Provider Demographics
NPI:1487016143
Name:HABEEB, HABEEB
Entity type:Individual
Prefix:
First Name:HABEEB
Middle Name:
Last Name:HABEEB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3410 FAR WEST BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3187
Mailing Address - Country:US
Mailing Address - Phone:512-717-9775
Mailing Address - Fax:512-599-5034
Practice Address - Street 1:3410 FAR WEST BLVD STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3187
Practice Address - Country:US
Practice Address - Phone:512-717-9775
Practice Address - Fax:512-599-5034
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18996207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program