Provider Demographics
NPI:1447222591
Name:HOWELLS, ABIODUN
Entity Type:Individual
Prefix:DR
First Name:ABIODUN
Middle Name:
Last Name:HOWELLS
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:PO BOX 848147
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-8147
Mailing Address - Country:US
Mailing Address - Phone:800-819-2547
Mailing Address - Fax:423-899-5295
Practice Address - Street 1:900 W ASH ST
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030-4000
Practice Address - Country:US
Practice Address - Phone:505-546-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2005-0194207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM43976522Medicaid
NM43976522Medicaid