Provider Demographics
NPI:1215927587
Name:ABOR, CALVIN J (PA)
Entity type:Individual
Prefix:
First Name:CALVIN
Middle Name:J
Last Name:ABOR
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:950 N 19TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2420
Mailing Address - Country:US
Mailing Address - Phone:325-670-3770
Mailing Address - Fax:325-670-3776
Practice Address - Street 1:950 N 19TH ST STE 100
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2420
Practice Address - Country:US
Practice Address - Phone:325-670-3770
Practice Address - Fax:325-670-3776
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA04496363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
8D5255Medicare PIN
Q45441Medicare UPIN