Provider Demographics
NPI:1982636551
Name:KAISSI, LUBNA M (MD)
Entity Type:Individual
Prefix:DR
First Name:LUBNA
Middle Name:M
Last Name:KAISSI
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 1:1200 BINZ ST STE 850
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-6933
Mailing Address - Country:US
Mailing Address - Phone:713-486-5660
Mailing Address - Fax:713-486-5661
Practice Address - Street 1:1200 BINZ ST STE 850
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-6933
Practice Address - Country:US
Practice Address - Phone:713-486-5660
Practice Address - Fax:713-486-5661
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1901207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B4031OtherBCBS PROVIDER ID NO.
TX00994MMedicare PIN
TX8B4031OtherBCBS PROVIDER ID NO.