Provider Demographics
NPI:1386692689
Name:KEYLANI, ABDUL MOEZ (MD FACC)
Entity type:Individual
Prefix:DR
First Name:ABDUL
Middle Name:MOEZ
Last Name:KEYLANI
Suffix:
Gender:M
Credentials:MD FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:321 RICHLAND WEST CIR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-7919
Mailing Address - Country:US
Mailing Address - Phone:542-359-3552
Mailing Address - Fax:254-235-0904
Practice Address - Street 1:321 RICHLAND WEST CIR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-7919
Practice Address - Country:US
Practice Address - Phone:254-235-9355
Practice Address - Fax:254-235-0904
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6007207RI0011X
CT035596207UN0901X, 207RC0000X
TX43952207UN0901X, 207RC0000X
TX43638207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX302224601Medicaid
OH3100398Medicaid
TXP01119884OtherRAILROAD MEDICARE
TX8DK205OtherBCBS
TXTXB158615Medicare PIN
TXP01119884OtherRAILROAD MEDICARE