Provider Demographics
NPI:1982208443
Name:ABSOLUTE IOM LLC
Entity Type:Organization
Organization Name:ABSOLUTE IOM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HASSE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN CNP
Authorized Official - Phone:713-255-5097
Mailing Address - Street 1:5318 WESLAYAN ST # 303
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1048
Mailing Address - Country:US
Mailing Address - Phone:972-412-5299
Mailing Address - Fax:469-453-3374
Practice Address - Street 1:9002 CHIMNEY ROCK RD # 254
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-2509
Practice Address - Country:US
Practice Address - Phone:972-412-5299
Practice Address - Fax:469-453-3374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-25
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Single Specialty