Provider Demographics
NPI:1538199708
Name:ASADUDDIN, ADIL (MD)
Entity type:Individual
Prefix:
First Name:ADIL
Middle Name:
Last Name:ASADUDDIN
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 1:18400 KATY FWY
Mailing Address - Street 2:SUITE 590
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-1286
Mailing Address - Country:US
Mailing Address - Phone:281-578-1200
Mailing Address - Fax:281-578-1255
Practice Address - Street 1:18400 KATY FRWY
Practice Address - Street 2:SUITE 590
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1110
Practice Address - Country:US
Practice Address - Phone:281-578-1200
Practice Address - Fax:281-578-1255
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-107158207R00000X
TXL5230207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036107158Medicaid
ILK16946Medicare ID - Type Unspecified
ILK16947Medicare ID - Type Unspecified
H70517Medicare UPIN