MEDICARE: MICHAEL H ANNABI MDPA

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	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952597395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL H ANNABI MDPA

Provider Business Mailing Address
First Line	:	4930 OSBORNE DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79922-1041
Country	:	US
Telephone Number	:	915-587-9455
Fax Number	:	915-587-9410

Provider Business Practice Location Address
First Line	:	4930 OSBORNE DR
Second Line	:	BLDG. A
City	:	EL PASO
State	:	TX
Zip	:	79922-1041
Country	:	US
Telephone Number	:	915-587-9455
Fax Number	:	915-581-1040

Authorized Official
Title or Position	:	OFFICE SUPERVISOR
Name	:	LORINA CHAVEZ
Credential	:
Telephone Number	:	915-587-9455

Provider Enumeration Date	:	09/19/2007
Last Update Date	:	11/11/2024

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