Provider Demographics
NPI:1528251006
Name:JOSEPH ABADOM
Entity type:Organization
Organization Name:JOSEPH ABADOM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JSOEPH
Authorized Official - Middle Name:O
Authorized Official - Last Name:ABADOM
Authorized Official - Suffix:
Authorized Official - Credentials:MASTERS OF SCIENCE
Authorized Official - Phone:832-245-6826
Mailing Address - Street 1:13803 BLUE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-2076
Mailing Address - Country:US
Mailing Address - Phone:832-245-6826
Mailing Address - Fax:
Practice Address - Street 1:13803 BLUE VISTA DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-2076
Practice Address - Country:US
Practice Address - Phone:832-245-6826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3104A0630X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances