Provider Demographics
NPI:1588663280
Name:IQBAL, IMRAN (MD)
Entity Type:Individual
Prefix:DR
First Name:IMRAN
Middle Name:
Last Name:IQBAL
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 1:8144 WALNUT HILL LN
Mailing Address - Street 2:SUITE 800
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4388
Mailing Address - Country:US
Mailing Address - Phone:214-540-0700
Mailing Address - Fax:214-540-0701
Practice Address - Street 1:8144 WALNUT HILL LN
Practice Address - Street 2:SUITE 800
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4388
Practice Address - Country:US
Practice Address - Phone:214-540-0700
Practice Address - Fax:214-540-0701
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-15
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8911174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8457M1Medicare PIN
TXG22557Medicare UPIN