Provider Demographics
NPI:1740560705
Name:EL-QADDOUMI, HIBA F (MD)
Entity Type:Individual
Prefix:
First Name:HIBA
Middle Name:F
Last Name:EL-QADDOUMI
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 1:16811 SOUTHWEST FREEWAY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479
Mailing Address - Country:US
Mailing Address - Phone:281-274-8050
Mailing Address - Fax:281-275-0760
Practice Address - Street 1:16811 SOUTHWEST FWY STE 300
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4728
Practice Address - Country:US
Practice Address - Phone:281-274-8050
Practice Address - Fax:281-275-0760
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP7104207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX362092401Medicaid