Provider Demographics
NPI:1023866605
Name:ABDRABBUH, OMER (MD)
Entity type:Individual
Prefix:MR
First Name:OMER
Middle Name:
Last Name:ABDRABBUH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:OMER
Other - Middle Name:
Other - Last Name:ABDRABBUH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:112 WELFORD LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092
Mailing Address - Country:US
Mailing Address - Phone:314-941-1518
Mailing Address - Fax:
Practice Address - Street 1:2311 MEDICAL DISTRICT DR
Practice Address - Street 2:SUPPORT BLDG., A RM 02.240
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235
Practice Address - Country:US
Practice Address - Phone:608-698-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program