Provider Demographics
NPI:1518622620
Name:HAZZ PEDIATRICS PLLC
Entity Type:Organization
Organization Name:HAZZ PEDIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HIBBA
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:HAIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-309-8065
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4321507-02Medicaid