Provider Demographics
NPI:1528038759
Name:BIBAWI, SAMER E (MD)
Entity Type:Individual
Prefix:
First Name:SAMER
Middle Name:E
Last Name:BIBAWI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 E PRESIDENT GEORGE BUSH HWY
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3561
Mailing Address - Country:US
Mailing Address - Phone:469-204-6100
Mailing Address - Fax:469-204-6194
Practice Address - Street 1:2805 E PRESIDENT GEORGE BUSH HWY
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3561
Practice Address - Country:US
Practice Address - Phone:469-204-6100
Practice Address - Fax:469-204-6194
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8715207R00000X, 207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX043113202Medicaid
8761893013OtherCIGNA HEALTH PLANS
7283221OtherAETNA PPO
NC130P9OtherBLUE CROSS AND BLUE SHIEL
NC89130P9Medicaid
VA006005322Medicaid
3600202OtherUNITED HEALTH CARE
NC46757OtherPARTNERS NATIONAL HEALTH
NCB3262OtherMEDCOST
TXP00453503OtherRAILROAD MEDICARE
3088796OtherAETNA HMO
TX8J9870Medicare PIN
NC46757OtherPARTNERS NATIONAL HEALTH
7283221OtherAETNA PPO
TX043113202Medicaid