Provider Demographics
NPI:1053445361
Name:PERINGOL, ABRAHAM K (MD)
Entity type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:K
Last Name:PERINGOL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14815 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5016
Mailing Address - Country:US
Mailing Address - Phone:281-565-2140
Mailing Address - Fax:281-565-2174
Practice Address - Street 1:14815 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5016
Practice Address - Country:US
Practice Address - Phone:281-565-2140
Practice Address - Fax:281-565-2174
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-5483207Q00000X
TXN3989207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX209572101Medicaid
TX209572101Medicaid
TXP00791008Medicare PIN