Provider Demographics
NPI:1679891634
Name:ABBE A LEDBETTER JR MD PA
Entity type:Organization
Organization Name:ABBE A LEDBETTER JR MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABBE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEDBETTER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:713-572-9100
Mailing Address - Street 1:4544 POST OAK PLACE DR
Mailing Address - Street 2:390
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3161
Mailing Address - Country:US
Mailing Address - Phone:713-572-9100
Mailing Address - Fax:713-572-9121
Practice Address - Street 1:4544 POST OAK PLACE DR
Practice Address - Street 2:390
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3161
Practice Address - Country:US
Practice Address - Phone:713-572-9100
Practice Address - Fax:713-572-9121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC8348207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB24294Medicare UPIN