Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 2006006967 | MO |
Y | 207RC0200X | Critical Care Medicine | P4015 | TX |
NPI | 1033206602 |
---|---|
Provider Name | Dr. Jamil Akhtar Abbasi |
First Address | Dallas, TX 75284-6098 |
Second Address | Tyler, TX 75701-2036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 21/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
204446603 | (05) | MO |
311795401 | (05) | TX |
752616977042 | TRICARE (01) | TX |
8DJ982 | BCBS (01) | TX |
I68705 | (02) | MO |