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Contact Information

4500 GULFWAY MEDICAL MANAGEMENT PA
4500 GULFWAY DRIVE
PORT ARTHUR, TX77642
 Phone: 409-982-5110
 Fax: 409-982-8196
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for 4500 GULFWAY MEDICAL MANAGEMENT PA

NPI Number 1326100439
LBN Legal business name 4500 GULFWAY MEDICAL MANAGEMENT PA
Authorized official ISAM ANABTAWI - (DOCTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 12/14/2006
Last updated 10/29/2007 - About 19 years ago
Identifiers
TX License # D5588
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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