Most Relevant Information
Provider Data
| NPI Number: | 1003003450 |
| Provider Name: | OMAR ANTONIO FABIAN |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 2056123 |
Most Important Dates
| Enumeration Date: | 10/01/2007 |
| Last Updated: | 10/01/2007 |
Provider Practice Location
2717 ROLLINGWOOD
TYLER
TX
75701
Practice Location Phone/Fax
| Phone: | 9032451844 |
| Fax: |
Provider Mailing Location
2717 ROLLINGWOOD DR
TYLER
TX
757016007
Provider Mailing Phone/Fax
| Phone: | 9032451844 |
| Fax: |