Provider Demographics
NPI:1760004782
Name:ABELL, ALICIA RENE (RT( R))
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:RENE
Last Name:ABELL
Suffix:
Gender:F
Credentials:RT( R)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16655 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2329
Mailing Address - Country:US
Mailing Address - Phone:281-276-8926
Mailing Address - Fax:
Practice Address - Street 1:16655 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2329
Practice Address - Country:US
Practice Address - Phone:281-276-8926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXGMR00108498247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist