Healthcare Provider Details

I. General information

NPI: 1639825490
Provider Name (Legal Business Name): MARIBEL ABARRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2022
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 CALLES ST
AUSTIN TX
78702-3954
US

IV. Provider business mailing address

11300 N LAMAR BLVD
AUSTIN TX
78753-2665
US

V. Phone/Fax

Practice location:
  • Phone: 855-481-8375
  • Fax:
Mailing address:
  • Phone: 866-389-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1054442
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: