MEDICARE: PHILIP DON ABBOTT 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
1	207VF0040X	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	C8872	TX
2	207VG0400X	Gynecology Physician	C8872	TX

General Provider Information

NPI Number	:	1811990401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP DON ABBOTT MD

Provider Business Mailing Address
First Line	:	3700 RUFE SNOW DR
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-8848
Country	:	US
Telephone Number	:	817-590-2395
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 RUFE SNOW DR
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-8848
Country	:	US
Telephone Number	:	817-590-2395
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	11/14/2013

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