Provider Demographics
NPI:1144420266
Name:KHABBAZEH, ZUKA A (MD)
Entity Type:Individual
Prefix:DR
First Name:ZUKA
Middle Name:A
Last Name:KHABBAZEH
Suffix:
Gender:F
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 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:956-362-2440
Mailing Address - Fax:956-362-2448
Practice Address - Street 1:2821 MICHAELANGELO DR STE 306
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-1418
Practice Address - Country:US
Practice Address - Phone:956-362-2440
Practice Address - Fax:956-362-2448
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ26372084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126568809Medicaid
TX309602YNG9Medicare PIN