Provider Demographics
NPI:1356392302
Name:NOUBANI, HASAN (MD)
Entity type:Individual
Prefix:DR
First Name:HASAN
Middle Name:
Last Name:NOUBANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HASAN
Other - Middle Name:MOHAMMED
Other - Last Name:NOUBANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2010 S CYNTHIA ST STE 102
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1387
Mailing Address - Country:US
Mailing Address - Phone:956-627-2330
Mailing Address - Fax:956-627-2267
Practice Address - Street 1:2010 S CYNTHIA ST STE 102
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1387
Practice Address - Country:US
Practice Address - Phone:956-627-2330
Practice Address - Fax:956-627-2267
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101236665174400000X
TXL70782080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152806904Medicaid
VA010106109Medicaid
TX152806904Medicaid
TXG02086Medicare UPIN