Basic Information
| Provider Information | |||||||||
| NPI: | 1740560705 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EL-QADDOUMI | ||||||||
| FirstName: | HIBA | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16811 SOUTHWEST FREEWAY | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77479 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812748050 | ||||||||
| FaxNumber: | 2812750760 | ||||||||
| Practice Location | |||||||||
| Address1: | 16811 SOUTHWEST FWY STE 300 | ||||||||
| Address2: | |||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774794728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812748050 | ||||||||
| FaxNumber: | 2812750760 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2011 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | P7104 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
ID Information
| ID | Type | State | Issuer | Description | 362092401 | 05 | TX | MEDICAID |