MEDICARE: ABRAHAM F SYRQUIN MD A PROFESSIONAL ASSOCIATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1003894585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABRAHAM F SYRQUIN MD A PROFESSIONAL ASSOCIATION

Provider Business Mailing Address
First Line	:	8913 RACQUET CLUB DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76120-2839
Country	:	US
Telephone Number	:	972-339-0990
Fax Number	:	817-460-6183

Provider Business Practice Location Address
First Line	:	8913 RACQUET CLUB DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76120-2839
Country	:	US
Telephone Number	:	972-339-0990
Fax Number	:	817-460-6183

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. ABRAHAM FINKLEBERG SYRQUIN
Credential	:	M.D.
Telephone Number	:	972-339-0990

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	11/13/2019

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