Healthcare Provider Details

I. General information

NPI: 1619773769
Provider Name (Legal Business Name): KAREEM HUSSEIN MAKKI ABOC, CPO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 HEATHER BROOK DR
ALLEN TX
75002-2775
US

IV. Provider business mailing address

1502 HEATHER BROOK DR
ALLEN TX
75002-2775
US

V. Phone/Fax

Practice location:
  • Phone: 972-730-6688
  • Fax:
Mailing address:
  • Phone: 972-730-6688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number240360
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: