Khuzam Abdalla, M.D

Individual provider Active NPI Pediatrics Physician · Abilene, TX

NPI 1174769137 · NPPES record last updated Aug 6, 2020

Key facts

NPI
1174769137
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
RS2008-0842 (NM)
Practice address
6300 Regional PLZ Ste 650
Abilene, TX 79606-5226
Phone
(325) 692-5800
Fax
(325) 692-6111
NPI assigned
Dec 22, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
RS2008-0842NMMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group West Texas, PLLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X RS2008-0842 NM Yes

Addresses

Primary practice location

6300 Regional PLZ Ste 650
Abilene, TX 79606-5226

Mailing address

PO Box 5409
Abilene, TX 79608-5409
Phone (325) 437-8655

Other providers in Abilene, TX

All providers in Abilene, TX · Pediatrics Physician in Texas

Sources for this page

Verify at the official NPI Registry.