Provider Demographics
NPI:1205023801
Name:AMRO HABIB OD LLC
Entity Type:Organization
Organization Name:AMRO HABIB OD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMRO
Authorized Official - Middle Name:NASHAT
Authorized Official - Last Name:HABIB
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:520-661-4555
Mailing Address - Street 1:7400 N CLEMENS WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-8261
Mailing Address - Country:US
Mailing Address - Phone:520-744-6721
Mailing Address - Fax:520-744-6724
Practice Address - Street 1:8280 N CORTARO RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-9393
Practice Address - Country:US
Practice Address - Phone:520-744-6721
Practice Address - Fax:520-744-6724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ01129261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery