Provider Demographics
NPI:1750314217
Name:ABBARA, MAHER (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHER
Middle Name:
Last Name:ABBARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MAHER
Other - Middle Name:AHMAD
Other - Last Name:ABBARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-0000
Mailing Address - Fax:
Practice Address - Street 1:10701 VINTAGE PRESERVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-2126
Practice Address - Country:US
Practice Address - Phone:713-442-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1244207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX211976002Medicaid
TX211976003Medicaid
TX211976001Medicaid
LA1476196Medicaid
TX211976003Medicaid
TX211976001Medicaid
TXH54E - 8L17578Medicare PIN
LA4J338Medicare PIN
LAI24982Medicare UPIN
TX503758YKTVMedicare PIN
TXC458 - 8L17577Medicare PIN
TX503758YKTXMedicare PIN