Provider Demographics
NPI:1962484378
Name:ANNABI, MICHAEL H (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:H
Last Name:ANNABI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4930 OSBORNE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79922-1041
Mailing Address - Country:US
Mailing Address - Phone:915-587-9455
Mailing Address - Fax:915-587-9410
Practice Address - Street 1:4930 OSBORNE
Practice Address - Street 2:BLDG A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79922-1041
Practice Address - Country:US
Practice Address - Phone:915-587-9455
Practice Address - Fax:915-587-9410
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-19
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK6800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX030826402Medicaid
TX030826402Medicaid
TXF36129Medicare UPIN