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General NPI Number Information
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NPI Number | 1710341961
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Entity Type | Individual
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Provider Name | MOHAMMAD HALAIBEH M.D
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Gender | Male
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Dates
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Enumeration Date | 04/13/2016
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 11221 KATY FWY STE 115
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City | HOUSTON
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State | TX
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Zip | 77079-2105
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Country | US
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Telephone | 800-991-6117
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Fax |
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Provider Business Mailing Address
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Address Line | 3820 NORTHDALE BLVD STE 201
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City | TAMPA
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State | FL
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Zip | 33624-1893
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Country | US
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Telephone | 800-991-6117
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | CDR0004239
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 312877
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | CDR0004239
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | U8731
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License Number State | TX
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