Individual provider Active NPI

Abdul Qadir Haseeb, M.D.

  • Pediatrics Physician
  • Magnolia, TX
National Provider Identifier
1962467605
Registry record updated Jun 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
K1836 Issued in TX
Practice address
18602 FM 1488 Rd
Suite 700
Magnolia, TX 77354-8508
Phone
(281) 252-0013
Fax
(281) 252-4464
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X K1836 TX
Pediatrics Physician 208000000X K1836 TX Primary

Addresses

Primary practice location

18602 FM 1488 Rd
Suite 700
Magnolia, TX 77354-8508

Mailing address

PO Box 1176
Waller, TX 77484
Phone (936) 931-3448

Other identifiers 5

IdentifierTypeStateIssuer
041760202MedicaidTX
041760204MedicaidTX
041760206MedicaidTX
041760208MedicaidTX
041760203MedicaidTX

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K1836TXMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Specialty Care Clinic Allergy & Immunology PastSince Jul 1, 2002 Accepting new patients
Childrens Specialty Care Clinic Allergy & Immunology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ahaseeb148933@memorialhermann.direct-ci.com

Organizations & group practices 2

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339113600000",
    "number": "1962467605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1176",
            "city": "WALLER",
            "state": "TX",
            "postal_code": "77484",
            "telephone_number": "936-931-3448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18602 FM 1488 RD",
            "address_2": "SUITE 700",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773548508",
            "telephone_number": "281-252-0013",
            "fax_number": "281-252-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASEEB",
        "first_name": "ABDUL",
        "middle_name": "QADIR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2012-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "TX",
            "license": "K1836",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K1836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041760202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041760204",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041760206",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041760208",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041760203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Magnolia, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; 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.