Provider Demographics
NPI:1831119882
Name:HABIB, ADIL (MD)
Entity Type:Individual
Prefix:DR
First Name:ADIL
Middle Name:
Last Name:HABIB
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 1:1411 N BECKLEY AVE
Mailing Address - Street 2:PAVILION III, SUITE 268
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203-1259
Mailing Address - Country:US
Mailing Address - Phone:214-947-4400
Mailing Address - Fax:214-947-4404
Practice Address - Street 1:1411 N BECKLEY AVE
Practice Address - Street 2:PAVILION III, SUITE 268
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1259
Practice Address - Country:US
Practice Address - Phone:214-947-4400
Practice Address - Fax:214-947-4404
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC180343207RG0100X, 207RT0003X
NV22749207RG0100X, 207RT0003X
TXP4451207RG0100X, 207RT0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RT0003XAllopathic & Osteopathic PhysiciansInternal MedicineTransplant Hepatology
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8DU043OtherBLUE CROSS & BLUE SHIELD OF TEXAS
TX290517YHMUMedicare PIN
TX8DU043OtherBLUE CROSS & BLUE SHIELD OF TEXAS