Individual
NIDAL I DABBASI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2009036267
MO
2085R0202X
Diagnostic Radiology Physician
Primary
L1304
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142172903
—
TX
05
—
142172904
—
TX
05
—
142172905
—
TX
01
—
300124925
MEDICARE RAILROAD
TX
Enumeration date
11/02/2005
Last updated
04/04/2023
Update your record
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