=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134517097
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NABIL ABBASI
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/30/2014
-----------------------------------------------------
Last Update Date | 05/16/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3005 LAKEVIEW PKWY STE 400
-----------------------------------------------------
City | ROWLETT
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75088-3320
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-979-6577
-----------------------------------------------------
Fax | 972-979-6951
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 790 REMINGTON BLVD
-----------------------------------------------------
City | BOLINGBROOK
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60440-4909
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-370-8206
-----------------------------------------------------
Fax | 517-435-3670
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OTT16757
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------