Provider Demographics
NPI:1528251162
Name:KHALYL-MAWAD, JANINE (MD)
Entity type:Individual
Prefix:DR
First Name:JANINE
Middle Name:
Last Name:KHALYL-MAWAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 BAYLOR PLZ RM 286A
Mailing Address - Street 2:DEPARTMENT OF PATHOLOGY
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3411
Mailing Address - Country:US
Mailing Address - Phone:713-798-4661
Mailing Address - Fax:713-798-5838
Practice Address - Street 1:1 BAYLOR PLZ RM 286A
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3411
Practice Address - Country:US
Practice Address - Phone:713-798-4661
Practice Address - Fax:713-798-5838
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG7834207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE79436Medicare UPIN
TX8K5746Medicare PIN