Provider Demographics
NPI:1063727154
Name:ABENTRIX, INC
Entity type:Organization
Organization Name:ABENTRIX, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MBAKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-682-6098
Mailing Address - Street 1:3141 INTERSTATE 30
Mailing Address - Street 2:SUITE C
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-2702
Mailing Address - Country:US
Mailing Address - Phone:214-682-6098
Mailing Address - Fax:972-686-6603
Practice Address - Street 1:3141 INTERSTATE 30
Practice Address - Street 2:SUITE C
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-2702
Practice Address - Country:US
Practice Address - Phone:214-682-6098
Practice Address - Fax:972-686-6603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000413332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies