Healthcare Provider Details

I. General information

NPI: 1386582864
Provider Name (Legal Business Name): CARL JEREMY ABUSTAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 MEDICAL CENTER RD
FORT HOOD TX
76544-5060
US

IV. Provider business mailing address

1965 CHELMSFORD PL
HOFFMAN ESTATES IL
60169-2532
US

V. Phone/Fax

Practice location:
  • Phone: 254-553-9089
  • Fax:
Mailing address:
  • Phone: 847-899-0785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: