Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | G7962 | TX |
NPI | 1710984893 |
---|---|
Provider Name | Mr. Stuart Lee Abramson |
First Address | San Angelo, TX 76902-7200 |
Second Address | San Angelo, TX 76903-5919 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2005 |
Last Update Date | 05/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
134844303 | (05) | TX |
E51557 | (02) | TX |