Provider Demographics
NPI:1356601207
Name:KHATIBI, ESTHER (MD)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:KHATIBI
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 1:5920 SARATOGA BLVD STE 450
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4124
Mailing Address - Country:US
Mailing Address - Phone:361-236-2156
Mailing Address - Fax:484-328-6595
Practice Address - Street 1:5920 SARATOGA BLVD STE 450
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4124
Practice Address - Country:US
Practice Address - Phone:361-236-2156
Practice Address - Fax:484-328-6595
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ2572207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX354493401Medicaid
TX1L4967OtherMEDICARE
TX354493402Medicaid
TXP02601819OtherMCRR