Provider Demographics
NPI:1225032899
Name:ABIJAY, JOSEPH ALBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ALBERT
Last Name:ABIJAY
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 1:318 N ALLEGHANEY AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-5052
Mailing Address - Country:US
Mailing Address - Phone:432-332-8856
Mailing Address - Fax:432-332-8860
Practice Address - Street 1:318 N ALLEGHANEY AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-5052
Practice Address - Country:US
Practice Address - Phone:432-332-8856
Practice Address - Fax:432-332-8860
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM38332084N0600X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM3833OtherMEDICAL LICENSE
TXPENDINGMedicaid
TX0018HQOtherBCBS GROUP #
TX1492258-01Medicaid
TX8V3717OtherBCBS INDIVIDUAL #
TXPENDINGMedicaid
TX1492258-01Medicaid
TX8K8108Medicare PIN
752964224OtherTIN#