Provider Demographics
NPI:1003229378
Name:HUMBLE CARDIAC AND ENDOVASCULAR
Entity Type:Organization
Organization Name:HUMBLE CARDIAC AND ENDOVASCULAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MUSTAPHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIBIRIGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-532-7311
Mailing Address - Street 1:5120 WOODWAY DR
Mailing Address - Street 2:SUITE 7012
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-1723
Mailing Address - Country:US
Mailing Address - Phone:713-532-7311
Mailing Address - Fax:888-230-6105
Practice Address - Street 1:1475 FM 1960 BYPASS RD E
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3909
Practice Address - Country:US
Practice Address - Phone:281-964-2100
Practice Address - Fax:281-964-4406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty