Basic Information
| Provider Information | |||||||||
| NPI: | 1609192426 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | TABIBIAN | ||||||||
| FirstName: | BENJAMIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6431 FANNIN STREET | ||||||||
| Address2: | SUITE MSB 1.434 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770305389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8323257222 | ||||||||
| FaxNumber: | 7135006829 | ||||||||
| Practice Location | |||||||||
| Address1: | 6431 FANNIN STREET | ||||||||
| Address2: | SUITE MSB 1.434 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770305389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8323257222 | ||||||||
| FaxNumber: | 7135006829 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2010 | ||||||||
| LastUpdateDate: | 06/13/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Q8653 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 20A12185 | CA | N | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.