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General NPI Number Information
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NPI Number | 1386582864
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Entity Type | Individual
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Provider Name | CARL JEREMY ABUSTAN DO
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Gender | Male
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Dates
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Enumeration Date | 03/24/2026
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Last Update Date | 03/24/2026
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Provider Practice Location Address
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Address Line | 590 MEDICAL CENTER RD
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City | FORT HOOD
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State | TX
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Zip | 76544-5060
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Country | US
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Telephone | 254-553-9089
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Fax |
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Provider Business Mailing Address
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Address Line | 1965 CHELMSFORD PL
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169-2532
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Country | US
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Telephone | 847-899-0785
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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