Provider Demographics
NPI:1881673465
Name:KANWAR, BADAR AQEEL (MD)
Entity Type:Individual
Prefix:
First Name:BADAR
Middle Name:AQEEL
Last Name:KANWAR
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 1:8600 SKYLINE DR APT 1000
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-4167
Mailing Address - Country:US
Mailing Address - Phone:866-813-2333
Mailing Address - Fax:
Practice Address - Street 1:8600 SKYLINE DR APT 1000
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-4167
Practice Address - Country:US
Practice Address - Phone:866-813-2333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6219207R00000X, 207RS0012X, 207RP1001X
WI35044-20207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX199844501Medicaid
TX199844502Medicaid
TX199844506Medicaid
F80392Medicare UPIN
TX8L8100Medicare PIN
WI002150265Medicare Oscar/Certification
TXTXB130465Medicare PIN
TX199844502Medicaid