Provider Demographics
NPI:1417412313
Name:DAVID, ABIONA ANTHONY
Entity Type:Individual
Prefix:
First Name:ABIONA
Middle Name:ANTHONY
Last Name:DAVID
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 ORTIZ DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-3564
Mailing Address - Country:US
Mailing Address - Phone:917-262-1137
Mailing Address - Fax:
Practice Address - Street 1:3024 ORTIZ DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-3564
Practice Address - Country:US
Practice Address - Phone:917-262-1137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX231811164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse