Provider Demographics
NPI:1538279807
Name:KATZ, ABRAHAM JACOBO (MD)
Entity Type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:JACOBO
Last Name:KATZ
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 1:1201 E SCHUSTER AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4673
Mailing Address - Country:US
Mailing Address - Phone:915-532-7799
Mailing Address - Fax:915-534-9140
Practice Address - Street 1:1201 E SCHUSTER AVE STE 6
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4673
Practice Address - Country:US
Practice Address - Phone:915-532-7799
Practice Address - Fax:915-534-9140
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH39682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8P1960OtherBCBS OF TEXAS
TX00744XMedicare ID - Type Unspecified
TXC17731Medicare UPIN