MEDICARE: DR. LUBNA M. KAISSI M.D.

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	207Q00000X	Family Medicine Physician	L1901	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8B4031	OTHER	TX	BCBS PROVIDER ID NO.

General Provider Information

NPI Number	:	1982636551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUBNA M. KAISSI M.D.

Provider Business Mailing Address
First Line	:	8810 HIGHWAY 6 STE 100
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-7104
Country	:	US
Telephone Number	:	713-486-1200
Fax Number	:	713-383-1491

Provider Business Practice Location Address
First Line	:	8810 HIGHWAY 6 STE 100
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-7104
Country	:	US
Telephone Number	:	713-486-1200
Fax Number	:	713-383-1491

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	06/28/2025

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