Provider Demographics
NPI:1639117666
Name:ILAHI, ZAINAB (MD)
Entity Type:Individual
Prefix:DR
First Name:ZAINAB
Middle Name:
Last Name:ILAHI
Suffix:
Gender:F
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:2790 LAKE VISTA DR
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3884
Practice Address - Country:US
Practice Address - Phone:972-459-1300
Practice Address - Fax:972-459-1382
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM17812085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175528203Medicaid
TX175528204Medicaid
TX8S3358OtherBLUE CROSS OF TEXAS
TX8S3358OtherBLUE CROSS OF TEXAS
TX175528203Medicaid
TXP00301748Medicare PIN
TX508310YM09Medicare PIN