Individual provider Active NPI

Mary Eldiwany Abdou, DDS

  • Dentist
  • Houston, TX
National Provider Identifier
1376831743
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
27229 Issued in TX
Practice address
1011 Augusta Dr
Ste. 209
Houston, TX 77057-2062
Phone
(713) 623-0700
NPI assigned
Jul 19, 2011
Last updated
Sep 20, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 27229 TX Primary

Addresses

Primary practice location

1011 Augusta Dr
Ste. 209
Houston, TX 77057-2062

Mailing address

1011 Augusta Dr
Ste. 209
Houston, TX 77057-2062
Phone (713) 623-0700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
27229TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1376831743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 AUGUSTA DR",
            "address_2": "STE. 209",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770572062",
            "telephone_number": "713-623-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 AUGUSTA DR",
            "address_2": "STE. 209",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770572062",
            "telephone_number": "713-623-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDOU",
        "first_name": "MARY",
        "middle_name": "ELDIWANY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "27229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; 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.