Healthcare Provider Details

I. General information

NPI: 1922765155
Provider Name (Legal Business Name): ABIGAIL HUFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2021
Last Update Date: 11/22/2021
Certification Date: 11/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 N MAIN ST
ROCKDALE TX
76567-2323
US

IV. Provider business mailing address

1011 CEDAR FALLS ST
ROUND ROCK TX
78681-5670
US

V. Phone/Fax

Practice location:
  • Phone: 512-446-2277
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1059326
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: