=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366059230
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALLA AL-HABIB MD PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/25/2020
-----------------------------------------------------
Last Update Date | 10/03/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6124 W PARKER RD STE 432
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75093-8124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-403-3100
-----------------------------------------------------
Fax | 972-403-3105
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6124 W PARKER RD STE 432
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75093-8124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-403-3100
-----------------------------------------------------
Fax | 972-403-3105
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MD/PRESIDENT
-----------------------------------------------------
Name | ALLA AL-HABIB
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 713-824-7499
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------