MEDICARE: CHERYL HASEEB FNP

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	363LF0000X	Family Nurse Practitioner	1194698	TX

General Provider Information

NPI Number	:	1366236127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL HASEEB FNP

Provider Business Mailing Address
First Line	:	2222 BISSONNET ST STE 103
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-2364
Country	:	US
Telephone Number	:	281-658-1045
Fax Number	:

Provider Business Practice Location Address
First Line	:	2222 BISSONNET ST STE 103
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-2364
Country	:	US
Telephone Number	:	281-658-1045
Fax Number	:

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

Provider Enumeration Date	:	04/07/2025
Last Update Date	:	04/10/2025

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