Provider Demographics
NPI:1164403218
Name:ABENE, MICHAEL VINCENT (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:VINCENT
Last Name:ABENE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3511 CORONDO CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-3729
Mailing Address - Country:US
Mailing Address - Phone:713-669-9413
Mailing Address - Fax:713-669-9413
Practice Address - Street 1:7500 SAN FELIPE ST
Practice Address - Street 2:SUITE 525
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-1723
Practice Address - Country:US
Practice Address - Phone:713-465-9282
Practice Address - Fax:713-465-9248
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ68392084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128924106Medicaid
TX128924107Medicaid
TXP00293687Medicare PIN
8B4812Medicare PIN
8A8052Medicare PIN
TXTXB159834Medicare PIN
TX8L0691Medicare PIN
TX128924106Medicaid
TXP00447551Medicare PIN