Provider Demographics
NPI:1831107275
Name:ABSY, JUMAH TAWFIQ (OD)
Entity Type:Individual
Prefix:DR
First Name:JUMAH
Middle Name:TAWFIQ
Last Name:ABSY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 ELMWOOD CT
Mailing Address - Street 2:
Mailing Address - City:PALESTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75801-0515
Mailing Address - Country:US
Mailing Address - Phone:903-723-3250
Mailing Address - Fax:
Practice Address - Street 1:501 E KOLSTAD ST
Practice Address - Street 2:
Practice Address - City:PALESTINE
Practice Address - State:TX
Practice Address - Zip Code:75801-2352
Practice Address - Country:US
Practice Address - Phone:903-723-3250
Practice Address - Fax:903-723-5550
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6978T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184083703Medicaid
TX6978TOtherLICENSE