Basic Information
| Provider Information | |||||||||
| NPI: | 1912543638 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AQRABAWI | ||||||||
| FirstName: | ODAI | ||||||||
| MiddleName: | MICHAEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3820 FARRINGTON ST | ||||||||
| Address2: | |||||||||
| City: | MESQUITE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751504259 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2145364151 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2920 N STEMMONS FWY | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752476103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146302331 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/18/2019 | ||||||||
| LastUpdateDate: | 11/18/2019 | ||||||||
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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 | 225100000X | 1325902 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.