Provider Demographics
NPI:1760445407
Name:ABOUMATAR, SAMI MOHAMAD (MD)
Entity type:Individual
Prefix:DR
First Name:SAMI
Middle Name:MOHAMAD
Last Name:ABOUMATAR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2200 PARK BEND DR
Mailing Address - Street 2:BLDG 2 STE 203
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5387
Mailing Address - Country:US
Mailing Address - Phone:512-339-8831
Mailing Address - Fax:512-339-8841
Practice Address - Street 1:2200 PARK BEND DR
Practice Address - Street 2:BLDG 2 STE 203
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5387
Practice Address - Country:US
Practice Address - Phone:512-339-8831
Practice Address - Fax:512-339-8841
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2007-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL67482084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXL6745OtherSTATE LICENSE NUMBER
TX1729519Medicaid
TXF94578Medicare UPIN
TX1729519Medicaid