Healthcare Provider Details

I. General information

NPI: 1598053092
Provider Name (Legal Business Name): JUAN ARIEL ABREU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2011
Last Update Date: 10/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 GESSNER RD STE 585
HOUSTON TX
77024-2529
US

IV. Provider business mailing address

915 GESSNER RD STE 585
HOUSTON TX
77024-2529
US

V. Phone/Fax

Practice location:
  • Phone: 713-486-6690
  • Fax: 713-464-6427
Mailing address:
  • Phone: 713-486-6690
  • Fax: 713-464-6427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD462544
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberS2205
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: