Healthcare Provider Details

I. General information

NPI: 1285670661
Provider Name (Legal Business Name): TREVOR RABIE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 01/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9055 KATY FWY STE 200
HOUSTON TX
77024-1629
US

IV. Provider business mailing address

9235 KATY FWY STE 400
HOUSTON TX
77024-1507
US

V. Phone/Fax

Practice location:
  • Phone: 713-461-2915
  • Fax: 713-461-2915
Mailing address:
  • Phone: 713-461-2915
  • Fax: 713-461-5307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG4384
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: