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NPI Code Detail

MEDICARE: DIA ABOCHAMH MD

MEDICARE:   DIA  ABOCHAMH  MD
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
1207RC0000XCardiovascular Disease PhysicianK2392TX
2207UN0901XNuclear Cardiology PhysicianK2392TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00177686OTHERTXRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1K2392OTHERTXLICENSE NO
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417952029
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIA ABOCHAMH MD
Provider Business Mailing Address
First Line : PO BOX 951406
Second Line :
City : DALLAS
State : TX
Zip : 75395-1406
Country : US
Telephone Number : 409-963-0000
Fax Number : 409-963-1899
Provider Business Practice Location Address
First Line : 3921 N TWIN CITY HWY
Second Line :
City : PORT ARTHUR
State : TX
Zip : 77642-2118
Country : US
Telephone Number : 409-963-0000
Fax Number : 409-963-1899
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 11/11/2016

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Directions to “ DIA ABOCHAMH MD” Practice Location

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