Provider Demographics
NPI:1588084867
Name:HARB, ALI HASSAN (MD)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:HASSAN
Last Name:HARB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 N INTERSTATE 35 E RD
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165
Mailing Address - Country:US
Mailing Address - Phone:469-843-4000
Mailing Address - Fax:
Practice Address - Street 1:2400 N INTERSTATE 35 E RD
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165
Practice Address - Country:US
Practice Address - Phone:469-843-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2024-04-30
Deactivation Date:2014-11-26
Deactivation Code:
Reactivation Date:2015-03-13
Provider Licenses
StateLicense IDTaxonomies
IN01078090A208M00000X
TXT8220207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist