Provider Demographics
NPI:1669498416
Name:ANNABI, JEFFREY HANI (MD)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:HANI
Last Name:ANNABI
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 1:7411 REMCON CIR STE B1
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3541
Mailing Address - Country:US
Mailing Address - Phone:915-584-9800
Mailing Address - Fax:915-584-9801
Practice Address - Street 1:7411 REMCON CIR STE B1
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3541
Practice Address - Country:US
Practice Address - Phone:915-584-9800
Practice Address - Fax:915-584-9801
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8267207L00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167415206Medicaid
TXTXB144843Medicare PIN