Provider Demographics
NPI:1871717884
Name:MIKHAIL, ADIB RIZKALLAH (MD)
Entity type:Individual
Prefix:MR
First Name:ADIB
Middle Name:RIZKALLAH
Last Name:MIKHAIL
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 1:34 LEISURE LANE
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1322
Mailing Address - Country:US
Mailing Address - Phone:281-298-6682
Mailing Address - Fax:281-364-8007
Practice Address - Street 1:34 LEISURE LANE
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1322
Practice Address - Country:US
Practice Address - Phone:281-298-6682
Practice Address - Fax:281-364-8007
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC400582084A0401X
TXE22922084P0800X
AZ86752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AM6328997OtherEND NUMBER
TX08489357OtherTXDL
R836Medicare ID - Type Unspecified