Provider Demographics
NPI:1275631921
Name:ADHAM, ABDALLAH N (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDALLAH
Middle Name:N
Last Name:ADHAM
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 1:3946 SOUTH BUCKNER
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227
Mailing Address - Country:US
Mailing Address - Phone:214-388-8181
Mailing Address - Fax:214-388-0141
Practice Address - Street 1:3946 SOUTH BUCKNER
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75227
Practice Address - Country:US
Practice Address - Phone:214-388-8181
Practice Address - Fax:214-388-0141
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0848207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP000FC951Medicare ID - Type Unspecified
E09061Medicare UPIN