Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | J6293 | TX |
N | 207YP0228X | Pediatric Otolaryngology | J6293 | TX |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | J6293 | TX |
NPI | 1033279807 |
---|---|
Provider Name | Dr. Omid Abbassi |
First Address | Baytown, TX 77521-7720 |
Second Address | Pearland, TX 77584-4890 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 30/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BA6812641 | DEA NUMBER (01) | |
H16629 | (02) | TX |