Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | P8238 | TX |
NPI | 1063676245 |
---|---|
Provider Name | Adi Diab |
First Address | Houston, TX 77210-4439 |
Second Address | Houston, TX 77030-4009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2008 |
Last Update Date | 17/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
328024001 | (05) | TX |
8ED196 | BCBS (01) | TX |
P01318857 | RR MEDICARE (01) | TX |