Provider Demographics
NPI:1174013569
Name:HADI, WIDIAN ABDUL
Entity type:Individual
Prefix:
First Name:WIDIAN
Middle Name:ABDUL
Last Name:HADI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 ST JOSEPH PKWY STE 1507
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8232
Mailing Address - Country:US
Mailing Address - Phone:713-756-5556
Mailing Address - Fax:713-756-5585
Practice Address - Street 1:1315 ST JOSEPH PKWY STE 1507
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8232
Practice Address - Country:US
Practice Address - Phone:713-756-5556
Practice Address - Fax:713-756-5585
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-11
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV9774208600000X
FLME167052208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty