Provider Demographics
NPI:1073736344
Name:ABBAS, JOHN CHIDI (Q)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CHIDI
Last Name:ABBAS
Suffix:
Gender:M
Credentials:Q
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 WINDING CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-6872
Mailing Address - Country:US
Mailing Address - Phone:214-371-6639
Mailing Address - Fax:241-372-6799
Practice Address - Street 1:3330 S LANCASTER RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-4531
Practice Address - Country:US
Practice Address - Phone:241-371-6639
Practice Address - Fax:214-372-6199
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health