Provider Demographics
NPI:1073832523
Name:ZUKA KHABBAZEH, M.D., P.A.
Entity Type:Organization
Organization Name:ZUKA KHABBAZEH, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZUKA
Authorized Official - Middle Name:A
Authorized Official - Last Name:KHABBAZEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-664-1999
Mailing Address - Street 1:5517 N MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2208
Mailing Address - Country:US
Mailing Address - Phone:956-664-1999
Mailing Address - Fax:
Practice Address - Street 1:5517 N MCCOLL RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2208
Practice Address - Country:US
Practice Address - Phone:956-664-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-24
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00T91VMedicare PIN