Provider Demographics
NPI:1457354813
Name:ABBAS, ASAD (MD)
Entity type:Individual
Prefix:DR
First Name:ASAD
Middle Name:
Last Name:ABBAS
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 1:1618 W BAKER RD.
Mailing Address - Street 2:STE A
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-2280
Mailing Address - Country:US
Mailing Address - Phone:281-420-3937
Mailing Address - Fax:281-420-1330
Practice Address - Street 1:1618 W BAKER RD.
Practice Address - Street 2:STE A
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2280
Practice Address - Country:US
Practice Address - Phone:281-420-3937
Practice Address - Fax:281-420-1330
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3898207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX153916502Medicaid
TX8K4794Medicare PIN
TXG74421Medicare UPIN