Healthcare Provider Details

I. General information

NPI: 1255386058
Provider Name (Legal Business Name): RIAD ALI ABOUJAMOUS NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3002 N CLOSNER BLVD SUITE B
EDINBURG TX
78541-7162
US

IV. Provider business mailing address

3002 N CLOSNER BLVD SUITE B
EDINBURG TX
78541-7162
US

V. Phone/Fax

Practice location:
  • Phone: 956-383-8300
  • Fax: 956-383-3006
Mailing address:
  • Phone: 956-383-8300
  • Fax: 956-383-3006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number647801
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: