| Abdul S Thannoun Md Pa | |
|
3501 Soncy Rd Ste 107 Amarillo TX 79119-6405 | |
| (806) 354-2400 | |
| (806) 354-8070 |
| Full Name | Abdul S Thannoun Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 3501 Soncy Rd Ste 107, Amarillo, Texas |
| Authorized Official Name and Position | Abdul S Thannoun (OWNER) |
| Authorized Official Contact | 8063542400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abdul S Thannoun Md Pa 3501 Soncy Rd Ste 107 Amarillo TX 79119-6405 Ph: (806) 354-2400 | Abdul S Thannoun Md Pa 3501 Soncy Rd Ste 107 Amarillo TX 79119-6405 Ph: (806) 354-2400 |
| NPI Number | 1790059848 |
|---|---|
| Provider Enumeration Date | 03/06/2012 |
| Last Update Date | 12/07/2023 |
| Medicare PECOS PAC ID | 0244499176 |
|---|---|
| Medicare Enrollment ID | O20120312000638 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790059848 | NPI | - | NPPES |
| 364174801 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | J0308 (Texas) | Primary |
| Provider Name | Abdul S Thannoun |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1962438713 PECOS PAC ID: 5890765416 Enrollment ID: I20040729001078 |
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