Provider Demographics
NPI:1639686603
Name:ABSTAR CARE LLC
Entity Type:Organization
Organization Name:ABSTAR CARE LLC
Other - Org Name:ABSTAR ACRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABIODUN
Authorized Official - Middle Name:
Authorized Official - Last Name:OWORU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-909-4462
Mailing Address - Street 1:12236 BOB WHITE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-5291
Mailing Address - Country:US
Mailing Address - Phone:713-729-3066
Mailing Address - Fax:
Practice Address - Street 1:12236 BOB WHITE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-5291
Practice Address - Country:US
Practice Address - Phone:713-729-3066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-29
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX018376253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care