Provider Demographics
NPI:1902301773
Name:ABBO, ELTAHIR M
Entity type:Individual
Prefix:
First Name:ELTAHIR
Middle Name:M
Last Name:ABBO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6610 HARWIN DR # 211
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2232
Mailing Address - Country:US
Mailing Address - Phone:623-703-2988
Mailing Address - Fax:623-234-9940
Practice Address - Street 1:6610 HARWIN DR # 211
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2232
Practice Address - Country:US
Practice Address - Phone:623-703-2988
Practice Address - Fax:623-234-9940
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)