Doctor Name: | BEVERLY ANNE ABBOTT |
NPI Number: | 1164724522 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 64367 |
Business Practice Address: | 107 Woodbine Pl Unit 775 Longview, TX - 756012912 |
Business Phone Number: | 9032372315 |
Business Fax Number: | 9037578294 |
Mailing Address: | 107 Woodbine Pl, Unit 775 LONGVIEW |
State: | TX |
Postal Code: | 756012912 |
Phone Number: | 9032372315 |
Fax Number: | 9037578294 |
NPI Enumeration Date: | 11/17/2010 |
NPI Last Update Date: | 11/17/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 64367 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |