Provider Demographics
NPI:1952757452
Name:HAIDER, ANSAB ABBAS (MBBS)
Entity type:Individual
Prefix:
First Name:ANSAB
Middle Name:ABBAS
Last Name:HAIDER
Suffix:
Gender:
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 S COULTER ST STE 204
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1765
Mailing Address - Country:US
Mailing Address - Phone:806-340-0550
Mailing Address - Fax:
Practice Address - Street 1:1301 S COULTER ST STE 204
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1765
Practice Address - Country:US
Practice Address - Phone:806-340-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-13
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN692292086S0129X
TXU23892086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery