Provider Demographics
NPI:1104001031
Name:DAHDEL, MAHER (MD)
Entity Type:Individual
Prefix:
First Name:MAHER
Middle Name:
Last Name:DAHDEL
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 1:501 ORCHARD ST 200
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4146
Mailing Address - Country:US
Mailing Address - Phone:281-557-8555
Mailing Address - Fax:281-554-3657
Practice Address - Street 1:501 ORCHARD ST 200
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4146
Practice Address - Country:US
Practice Address - Phone:281-557-8555
Practice Address - Fax:281-554-3657
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125048872390200000X
ARE7004207RP1001X
TXQ5785207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200342370AMedicaid
AR187330001Medicaid
OK200342370AMedicaid
AR187330001Medicaid