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NPI Code Detail

MEDICARE: ELIZABETH ANN ABE

MEDICARE: ELIZABETH ANN ABE
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1558191684
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH ANN ABE
Provider Business Mailing Address
First Line : 5114 MEDICAL DR APT 2326
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-3876
Country : US
Telephone Number : 810-877-4087
Fax Number :
Provider Business Practice Location Address
First Line : 5114 MEDICAL DR APT 2326
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-3876
Country : US
Telephone Number : 810-877-4087
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2024
Last Update Date : 08/05/2024

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