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General NPI Number Information
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NPI Number | 1780712620
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Entity Type | Organization
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Legal Business Name | ABREU ADULT CLINIC P A
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 910 S BRYAN RD STE 105
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City | MISSION
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State | TX
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Zip | 78572-6615
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Country | US
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Telephone | 956-581-0539
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Fax | 956-585-0745
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Provider Business Mailing Address
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Address Line | 910 S BRYAN RD SUITE 105
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City | MISSION
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State | TX
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Zip | 78572-6658
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Country | US
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Telephone | 956-581-0539
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Fax | 956-323-1499
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARITY VIRGINIA ABREU-LAWRENCE
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Credential | M.D.
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Telephone | 956-581-0539
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | J8856
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License Number State | TX
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