Provider Demographics
NPI:1629033378
Name:HOURANI, ABDULKADIR (MD)
Entity Type:Individual
Prefix:
First Name:ABDULKADIR
Middle Name:
Last Name:HOURANI
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 1:2051 W 25TH ST
Mailing Address - Street 2:STE D
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6912
Mailing Address - Country:US
Mailing Address - Phone:928-344-4111
Mailing Address - Fax:
Practice Address - Street 1:2051 W 25TH ST
Practice Address - Street 2:STE D
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6912
Practice Address - Country:US
Practice Address - Phone:928-344-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25270207R00000X, 207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ339221Medicaid
AZP00276457Medicare PIN
AZ339221Medicaid
AZZ106607Medicare PIN