Provider Demographics
NPI:1972751642
Name:HAIDER, HIBBA A (MD)
Entity type:Individual
Prefix:DR
First Name:HIBBA
Middle Name:A
Last Name:HAIDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HIBBA
Other - Middle Name:A
Other - Last Name:BOKHARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:20826 MEADOWHILL DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4236
Mailing Address - Country:US
Mailing Address - Phone:816-309-8065
Mailing Address - Fax:
Practice Address - Street 1:1113 W BAKER RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2391
Practice Address - Country:US
Practice Address - Phone:281-838-8412
Practice Address - Fax:888-498-3262
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS94-07109208000000X
TXS8564208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4321507-01Medicaid
KS201069150Medicaid