Omar Antonio Fabian

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2056123 Issued in TX

Practice address

2717 Rollingwood
Tyler, TX 75701

Phone

(903) 245-1844

NPI assigned

Oct 1, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1003003450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 ROLLINGWOOD DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757016007",
            "telephone_number": "903-245-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 ROLLINGWOOD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-245-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABIAN",
        "first_name": "OMAR",
        "middle_name": "ANTONIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-01",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2056123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthonia Nkechi Ezeigwe, R.N.
• Ifeoma Juliet Ezeigwe, NP
• Lilian Eziefule
• Malak Ezzat, MD
• Robert Immanuel Fabela Jr.
• Damilola Fabiyi
• Alexxa Dominique Facio
• Marian Frances Fagan, MD
• Farzad Fakouri, M.D. , MPH
• Amanda L Falbo, PMHNP

• Physical Therapy Assistant in Tyler, TX
• Providers in Tyler, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.