NUSRATH MOHIDEEN HABIBA


Address: 855 Montgomery St, Fort Worth, TX 76107-2553
Phone: 8177352363

NUSRATH MOHIDEEN HABIBA (NPI# 1568657104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1568657104
Entity Type Individual
Full Name NUSRATH MOHIDEEN HABIBA
Credential MD
Practice Address 855 Montgomery St
Fort Worth
TX 76107-2553
Mailing Address Po Box 99335
Fort Worth
TX 76199-0335
Practice Telephone 8177352363
Mailing Telephone 8177352363
Enumeration Date 2007-09-06
Last Update Date 2012-02-16
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208000000X Pediatrics N0813 TX Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
TX BCBS 8F9744 01
TX 198519401 05

Office Location

Street Address 855 MONTGOMERY ST
City FORT WORTH
State TX
Zip Code 76107-2553

Providers in the same location

NPI Name Taxonomy Address Enumeration
1831194455 Patricia Lowrimore Psychiatry & Neurology 855 Montgomery St, Fort Worth, TX 76107-2553 2005-06-20
1194353417 Jason L Thompson Student in an Organized Health Care Education/Training Program 855 Montgomery St, Fort Worth, TX 76107-2553 2020-03-31
1639701808 Tyrane Roberts-lagrone Pharmacist 855 Montgomery St, Fort Worth, TX 76107-2553 2020-02-06
1144860917 Melissa Edwards Petersen Clinical Neuropsychologist 855 Montgomery St, Fort Worth, TX 76107-2553 2020-01-09
1629553813 Lisa Jane Killam-worrall Pharmacist 855 Montgomery St, Fort Worth, TX 76107-2553 2018-10-03
1598250607 Sima Taj Mozdbar Optometrist 855 Montgomery St, Fort Worth, TX 76107-2553 2018-06-30
1588153993 Kristen Reuter Social Worker 855 Montgomery St, Fort Worth, TX 76107-2553 2018-05-02
1114431624 Emily J. Clark Counselor 855 Montgomery St, Fort Worth, TX 76107-2553 2017-11-20
1275073215 Elizabeth Svyatoslavna Balyakina Student in an Organized Health Care Education/Training Program 855 Montgomery St, Fort Worth, TX 76107-2553 2017-02-23
1588103659 Frederick Olen Barnum Iv Family Medicine 855 Montgomery St, Fort Worth, TX 76107-2553 2017-02-21
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1629683602 Renovo Wound and Hyperbarics Pllc Emergency Medicine 5668 Edwards Ranch Road, Suite 101, Fort Worth, TX 76107 2020-09-15
1669085437 Ryan Bourgeois Nurse Practitioner 2917 Crocket Street, Fort Worth, TX 76107 2020-08-31
1053920546 Christa Marie Widjaja Optometrist 1700 Montgomery St, Fort Worth, TX 76107 2020-07-30
1093351355 Raymond Iannone Pharmacist 850 Montgomery St, Suite #310, Fort Worth, TX 76107 2019-11-21
1053963744 Cumulus Injury Resolution, Inc. Chiropractor 4936 Byers Avenue, Fort Worth, TX 76107 2019-07-12
1770135576 Shadia Osakwe Physician Assistant 855 Montgomery Street, Pediatric Clinic, Fort Worth, TX 76107 2019-07-11
1568945442 Sachin P Patel Physical Therapist 4825 Wellesley St, Fort Worth, TX 76107 2018-09-07
1023594025 Ftw Pharmacy Services Inc Durable Medical Equipment & Medical Supplies 2912 W 6th St Ste 150, Fort Worth, TX 76107 2018-07-13
1669974325 Helen Williamson Elliott Counselor 1751 River Run #217, Fort Worth, TX 76107 2018-03-08
1487156931 Pelvic Neuromonitoring Pllc Electrodiagnostic Medicine 111 Boland St #211, Ft Worth, TX 76107 2018-03-01
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Taxonomy Information

Taxonomy Code 208000000X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics

Taxonomy Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio
- Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1376165191 Telemedicine Advantage Concierge Urgent Care Pediatrics 4200 South Fwy Ste 100, Fort Worth, TX 76115-1407 2020-05-14
1942776638 Melissa S Wright Pediatrics 6115 Camp Bowie Blvd, Fort Worth, TX 76116-5512 2018-10-19
1366975336 Pragadeeswari Dhanasekaran Pediatrics 5887 Chesapeake Pl, Fort Worth, TX 76132-2660 2017-04-06
1275898280 Suvarna Kolluri Pediatrics 9509 N Beach St Ste 102, Fort Worth, TX 76244-6399 2012-07-06
1881999613 Joyce Keck Rafati Pediatrics 1263 W Rosedale St, Fort Worth, TX 76104-2801 2011-01-26
1386886802 Eriel Hayes Pediatrics 3200 Riverfront Dr Ste 103, Fort Worth, TX 76107-6560 2009-03-30
1194980011 Cherryll Phoebe Taruc Libed Pediatrics 4701 Bryant Irvin Rd. N, Jps Viola Pitts/como, Fort Worth, TX 76107-4917 2008-07-21
1366605735 Carolyn Margaret Lentzsch-parcells Pediatrics 4200 South Hulen Stree, Suite 450, Fort Worth, TX 76109 2008-07-07
1366627655 Courtney M Carter Pediatrics 3201 Western Center Blvd, Suite 125, Fort Worth, TX 76137-7134 2008-01-04
1902017494 Raheela Hafeez,m.d., P.a. Pediatrics 855 Montgomery Street, Fort Worth, TX 76107-2553 2007-05-25
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Competitor

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City FORT WORTH
Zip Code 76107

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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