Provider Demographics
NPI:1932991122
Name:ABALO REDDEN, JORGE EDUARDO (FNP)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:EDUARDO
Last Name:ABALO REDDEN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:DR
Other - First Name:GEORGE
Other - Middle Name:EDUARDO
Other - Last Name:ABALO REDDEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:21550 PROVINCIAL BLVD APT 306
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6096
Mailing Address - Country:US
Mailing Address - Phone:281-935-6823
Mailing Address - Fax:
Practice Address - Street 1:21550 PROVINCIAL BLVD APT 306
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-6096
Practice Address - Country:US
Practice Address - Phone:281-935-6823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY356230363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily