1154678399 NPI number — MICHAEL V ABENE MD PA

Table of content: (NPI 1154678399)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154678399 NPI number — MICHAEL V ABENE MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MICHAEL V ABENE MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154678399
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3511 CORONDO CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77005-3729
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-699-9413
Provider Business Mailing Address Fax Number:
713-699-9413

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7500 SAN FELIPE ST
Provider Second Line Business Practice Location Address:
STE 525
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77063-1723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-465-9282
Provider Business Practice Location Address Fax Number:
713-465-9248
Provider Enumeration Date:
08/07/2012

Additional Information

Authorized Official

Authorized Official Last Name:
ABENE
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
VINCENT
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
713-922-2456

Provider Taxonomy Codes

  • Taxonomy code: 2084S0012X , with the licence number:  J6839 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: J6839 . This is a "TEXAS MEDICAL LICENSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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