=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851100614
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TABIB PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/06/2025
-----------------------------------------------------
Last Update Date | 03/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24518 NORTHWEST FWY STE 355
-----------------------------------------------------
City | CYPRESS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77429-2358
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 346-537-5999
-----------------------------------------------------
Fax | 346-537-5997
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12320 BARKER CYPRESS RD STE 600 #1052
-----------------------------------------------------
City | CYPRESS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77429-8323
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 346-537-5999
-----------------------------------------------------
Fax | 346-537-5997
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | ISMAIL HADER
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 346-537-5999
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------