MEDICARE: PEARLAND ENT PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174708564
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEARLAND ENT PA

Provider Business Mailing Address
First Line	:	2225 COUNTY ROAD 90
Second Line	:	SUITE 123
City	:	PEARLAND
State	:	TX
Zip	:	77584-4890
Country	:	US
Telephone Number	:	281-412-6100
Fax Number	:	281-412-2423

Provider Business Practice Location Address
First Line	:	2225 COUNTY ROAD 90 STE 123
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-4891
Country	:	US
Telephone Number	:	281-412-6100
Fax Number	:	281-412-2423

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	DR. OMID ABBASSI
Credential	:	MD-PHD
Telephone Number	:	281-412-6100

Provider Enumeration Date	:	01/03/2008
Last Update Date	:	01/28/2019

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Directions to “PEARLAND ENT PA ” Practice Location

Language	Start Address	Practice Location

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