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General NPI Number Information
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NPI Number | 1073912994
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Entity Type | Organization
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Legal Business Name | ABROSMAG MEDICAL CLINIC & REHAB INC
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Dates
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Enumeration Date | 08/15/2014
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Last Update Date | 03/30/2017
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Provider Practice Location Address
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Address Line | 6220 WESTPARK DR 224
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City | HOUSTON
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State | TX
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Zip | 77057-7371
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Country | US
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Telephone | 832-740-4932
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Fax | 832-740-4946
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Provider Business Mailing Address
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Address Line | 6220 WESTPARK DR 224
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City | HOUSTON
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State | TX
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Zip | 77057-7371
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Country | US
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Telephone | 832-740-4932
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Fax | 832-740-4946
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Authorized Official
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Title or Position | DIRECTOR
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Name | APPOLONARIS DZE
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Credential |
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Telephone | 832-740-4932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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