Individual provider Active NPI

Abdulmajed Ibrahim Hajjaraby, MLS

  • Clinical Laboratory Director (Non-physician)
  • Euless, TX
National Provider Identifier
1881265130
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X
License
4585 Issued in TX
Practice address
350 Westpark Way Ste 101a
Euless, TX 76040-3964
Phone
(817) 513-1689
NPI assigned
Jul 8, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Laboratory Director (Non-physician) 247ZC0005X 4585 TX Primary

Addresses

Primary practice location

350 Westpark Way Ste 101a
Euless, TX 76040-3964

Mailing address

350 Westpark Way Ste 101a
Euless, TX 76040-3964
Phone (817) 513-1689

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4585TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Ultralab Clinical Medical Laboratory Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1881265130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 WESTPARK WAY STE 101A",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760403964",
            "telephone_number": "817-513-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 WESTPARK WAY STE 101A",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760403964",
            "telephone_number": "817-513-1689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAJJARABY",
        "first_name": "ABDULMAJED",
        "middle_name": "IBRAHIM",
        "credential": "MLS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": "TX",
            "license": "4585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Euless, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.