Provider Demographics
NPI:1780655779
Name:QAVI, ABDUL (MD)
Entity Type:Individual
Prefix:
First Name:ABDUL
Middle Name:
Last Name:QAVI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 852756
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75185-2756
Mailing Address - Country:US
Mailing Address - Phone:214-660-2533
Mailing Address - Fax:972-744-0132
Practice Address - Street 1:929 N GALLOWAY AVE
Practice Address - Street 2:STE 220
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-2476
Practice Address - Country:US
Practice Address - Phone:214-660-2533
Practice Address - Fax:972-744-0132
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL7527207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163527801Medicaid
H42624Medicare UPIN
TX8B4773Medicare PIN