Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | J2579 | TX |
N | 207RX0202X | Medical Oncology | J2579 | TX |
NPI | 1043259476 |
---|---|
Provider Name | Dr. Habib Mohammad-Hussein Ghaddar |
First Address | Dallas, TX 75391-1230 |
Second Address | Weslaco, TX 78596-4204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 31/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
137030601 | (05) | TX |
137030602 | (05) | TX |
137030603 | (05) | TX |
137030605 | CSHCN (01) | TX |
137030606 | CSHCN (01) | TX |
137030607 | (05) | TX |
137030609 | CSHCN (01) | TX |
8R1443 | BLUE CROSS OF TEXAS (01) | TX |
F46209 | (02) | TX |