Provider Demographics
NPI:1841201316
Name:DORIA, ABELARDO SABANGAN (MD)
Entity Type:Individual
Prefix:
First Name:ABELARDO
Middle Name:SABANGAN
Last Name:DORIA
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 1:403 S 7TH STREET
Mailing Address - Street 2:
Mailing Address - City:CARRIZO SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78834
Mailing Address - Country:US
Mailing Address - Phone:830-876-9870
Mailing Address - Fax:830-876-3661
Practice Address - Street 1:403 S 7TH STREET
Practice Address - Street 2:
Practice Address - City:CARRIZO SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78834
Practice Address - Country:US
Practice Address - Phone:830-876-9870
Practice Address - Fax:830-876-3661
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0721208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120597303OtherCIDE
TX120597302Medicaid
TX89320XOtherBCBS
TX488963ZUNLOtherMEDICARE PART B
TX488963ZUNLOtherMEDICARE PART B
G30311Medicare UPIN