Provider Demographics
NPI:1770013245
Name:KUMAR, ABHIN
Entity Type:Individual
Prefix:
First Name:ABHIN
Middle Name:
Last Name:KUMAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 S CENTER ST STE 140
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2155
Mailing Address - Country:US
Mailing Address - Phone:901-390-2930
Mailing Address - Fax:
Practice Address - Street 1:3050 S CENTER ST STE 140
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2155
Practice Address - Country:US
Practice Address - Phone:817-557-1006
Practice Address - Fax:817-557-2000
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002679213ES0103X
TN871213ES0103X
TX692033213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery