Provider Demographics
NPI:1538456660
Name:HADER, ISMAIL M (MD)
Entity type:Individual
Prefix:
First Name:ISMAIL
Middle Name:M
Last Name:HADER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12320 BARKER CYPRESS RD
Mailing Address - Street 2:STE 600 #1052
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-8323
Mailing Address - Country:US
Mailing Address - Phone:346-537-5999
Mailing Address - Fax:346-537-5997
Practice Address - Street 1:24518 NORTHWEST FWY STE 355
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-2358
Practice Address - Country:US
Practice Address - Phone:346-537-5999
Practice Address - Fax:346-537-5997
Is Sole Proprietor?:No
Enumeration Date:2011-07-10
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301103117207R00000X
OH57.017380207R00000X
TXU3225207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine