Provider Demographics
NPI:1679777452
Name:KHALIL, ABRAHAM K (MD)
Entity Type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:K
Last Name:KHALIL
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 1:634 MANCHESTER TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-8293
Mailing Address - Country:US
Mailing Address - Phone:832-212-2848
Mailing Address - Fax:
Practice Address - Street 1:634 MANCHESTER TRAIL DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-8293
Practice Address - Country:US
Practice Address - Phone:832-212-2848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5768207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX359927AW3XOtherMEDICARE
TX359927ZLGMMedicare PIN
TXTXB111366Medicare PIN