Beverly Anne Abbott
Individual provider Active NPI Specialist · Longview, TX
NPI 1164724522 · NPPES record last updated Nov 17, 2010
Key facts
- NPI
- 1164724522
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 64367 (TX)
- Practice address
- 107 Woodbine PL
Unit 775
Longview, TX 75601-2912 - Phone
- (903) 237-2315
- Fax
- (903) 757-8294
- NPI assigned
- Nov 17, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sabine Valley Regional MHMR Center | Specialist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 64367 | TX | Yes |
Addresses
Primary practice location
107 Woodbine PL
Unit 775
Longview, TX 75601-2912
Mailing address
107 Woodbine PL
Unit 775
Longview, TX 75601-2912
Phone (903) 237-2315
Other providers in Longview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.