Healthcare Provider Details

I. General information

NPI: 1649655317
Provider Name (Legal Business Name): ABIGAIL BROOKS CALLAHAN AC-PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABIGAIL CHRISTINE BROOKS RN

II. Dates (important events)

Enumeration Date: 07/23/2015
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9525 GREENVILLE AVE
DALLAS TX
75243-4116
US

IV. Provider business mailing address

110 N CLEARWATER DR
HIGHLAND VILLAGE TX
75077-6718
US

V. Phone/Fax

Practice location:
  • Phone: 281-409-6011
  • Fax:
Mailing address:
  • Phone: 619-723-3895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP95001371
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1146506
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: