Provider Demographics
NPI:1780987636
Name:NABIL K ABOUKHAIR MD PA
Entity type:Organization
Organization Name:NABIL K ABOUKHAIR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:NABIL
Authorized Official - Middle Name:K
Authorized Official - Last Name:ABOUKHAIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-558-1888
Mailing Address - Street 1:825 N NOLAN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-7001
Mailing Address - Country:US
Mailing Address - Phone:817-558-1888
Mailing Address - Fax:817-645-1506
Practice Address - Street 1:825 N NOLAN RIVER RD
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-7001
Practice Address - Country:US
Practice Address - Phone:817-558-1888
Practice Address - Fax:817-645-1506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-15
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9739174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1283798-03Medicaid
TX1283798-03Medicaid