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General NPI Number Information
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NPI Number | 1689560096
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Entity Type | Individual
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Provider Name | HIBA SAMAR IQBAL DDS
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Gender | Female
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Dates
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Enumeration Date | 06/13/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 6014 AZLE AVE # 100
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City | LAKE WORTH
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State | TX
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Zip | 76135-2603
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Country | US
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Telephone | 817-529-5007
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Fax | 817-529-5011
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Provider Business Mailing Address
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Address Line | 2850 N BONNIE BRAE ST APT 429
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City | DENTON
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State | TX
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Zip | 76207-1169
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Country | US
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Telephone | 585-981-0700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 41560
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License Number State | TX
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