Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | C8872 | TX |
N | 207VG0400X | Gynecologist | C8872 | TX |
NPI | 1811990401 |
---|---|
Provider Name | Philip Don Abbott |
First Address | North Richland Hills, TX 76180-8848 |
Second Address | North Richland Hills, TX 76180-8848 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2005 |
Last Update Date | 14/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C12562 | (02) | TX |