Individual provider Active NPI

Abraham Abdo, M.D.

  • Orthopaedic Surgery Physician
  • Mesquite, TX
National Provider Identifier
1619083326
Registry record updated Dec 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G0647 Issued in TX
Practice address
2698 N Galloway Ave
Ste 105
Mesquite, TX 75150-6383
Phone
(972) 613-4488
Fax
(972) 613-1975
NPI assigned
Aug 23, 2006
Last updated
Dec 31, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G0647 TX Primary

Addresses

Primary practice location

2698 N Galloway Ave
Ste 105
Mesquite, TX 75150-6383

Mailing address

2698 N Galloway Ave
Ste 105
Mesquite, TX 75150-6383
Phone (972) 613-4488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050519000119 TX Practitioner - Orthopedic Surgery 4688615784 Practice locations: Mesquite, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G0647TXMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John C.H. Wang, DO, PA Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199059200000",
    "number": "1619083326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2698 N GALLOWAY AVE",
            "address_2": "STE 105",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506383",
            "telephone_number": "972-613-4488",
            "fax_number": "972-613-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2698 N GALLOWAY AVE",
            "address_2": "STE 105",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506383",
            "telephone_number": "972-613-4488",
            "fax_number": "972-613-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDO",
        "first_name": "ABRAHAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "G0647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.