Provider Demographics
NPI:1962467605
Name:HASEEB, ABDUL QADIR (MD)
Entity type:Individual
Prefix:DR
First Name:ABDUL
Middle Name:QADIR
Last Name:HASEEB
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:PO BOX 1176
Mailing Address - Street 2:
Mailing Address - City:WALLER
Mailing Address - State:TX
Mailing Address - Zip Code:77484
Mailing Address - Country:US
Mailing Address - Phone:936-931-3448
Mailing Address - Fax:
Practice Address - Street 1:18602 FM 1488 RD
Practice Address - Street 2:SUITE 700
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-8508
Practice Address - Country:US
Practice Address - Phone:281-252-0013
Practice Address - Fax:281-252-4464
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1836207K00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX041760202Medicaid
TX041760204Medicaid
TX041760206Medicaid
TX041760208Medicaid
TX041760203Medicaid
TX041760202Medicaid