Basic Information
Provider Information
NPI: 1770177594
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YOUMANS
FirstName: ABYGAIL
MiddleName: B
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7401 MAIN ST
Address2:  
City: HOUSTON
State: TX
PostalCode: 770304509
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 7401 MAIN ST
Address2:  
City: HOUSTON
State: TX
PostalCode: 770304509
CountryCode: US
TelephoneNumber: 7137992300
FaxNumber: 7137943380
Other Information
ProviderEnumerationDate: 02/23/2021
LastUpdateDate: 09/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X  N Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 
363AS0400XPA14349TXY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical

No ID Information.


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