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1003003450
OMAR ANTONIO FABIAN
TYLER, TX
NPI
1003003450
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: TX 2056123)
Enumeration Date
2007-10-01
Last Update Date
2007-10-01
Business Address
-- OMAR ANTONIO FABIAN
2717 ROLLINGWOOD
TYLER, TX 75701
Phone number: 903-245-1844
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Mailing Address
-- OMAR ANTONIO FABIAN
2717 ROLLINGWOOD DR
TYLER, TX 75701-6007
Phone number: 903-245-1844
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