MEDICARE: HEBAALLA ABDELKADER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	39775	TX

General Provider Information

NPI Number	:	1144907353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEBAALLA ABDELKADER

Provider Business Mailing Address
First Line	:	680 W SAM HOUSTON PKWY S APT 2516
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-1571
Country	:	US
Telephone Number	:	832-507-4512
Fax Number	:

Provider Business Practice Location Address
First Line	:	680 W SAM HOUSTON PKWY S APT 2516
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-1571
Country	:	US
Telephone Number	:	832-507-4512
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2023
Last Update Date	:	06/29/2023

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Directions to “ HEBAALLA ABDELKADER ” Practice Location

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