Provider Demographics
NPI:1073912994
Name:ABROSMAG MEDICAL CLINIC & REHAB INC
Entity Type:Organization
Organization Name:ABROSMAG MEDICAL CLINIC & REHAB INC
Other - Org Name:ABROSMAG MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:APPOLONARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-740-4932
Mailing Address - Street 1:6220 WESTPARK DR
Mailing Address - Street 2:224
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7371
Mailing Address - Country:US
Mailing Address - Phone:832-740-4932
Mailing Address - Fax:832-740-4946
Practice Address - Street 1:6220 WESTPARK DR
Practice Address - Street 2:224
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7371
Practice Address - Country:US
Practice Address - Phone:832-740-4932
Practice Address - Fax:832-740-4946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-15
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty