Provider Demographics
NPI:1336510791
Name:ABEABOERU, MARIUS DANIEL (FNP)
Entity Type:Individual
Prefix:
First Name:MARIUS
Middle Name:DANIEL
Last Name:ABEABOERU
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 NORTH MOPAC EXPRESSWAY
Mailing Address - Street 2:GREYSTONE PLAZA SUITE 370
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731
Mailing Address - Country:US
Mailing Address - Phone:512-346-4933
Mailing Address - Fax:512-346-4934
Practice Address - Street 1:7200 NORTH MOPAC EXPRESSWAY
Practice Address - Street 2:GREYSTONE PLAZA SUITE 370
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731
Practice Address - Country:US
Practice Address - Phone:512-346-4933
Practice Address - Fax:512-346-4934
Is Sole Proprietor?:No
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129220363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP129220OtherAPRN LICENSE NO: AP129220