Staton Omo-Abu
Technician in Dallas, TX. Individual provider (NPI-1).
NPI number1881466548
StatusActive
Last updated in NPPESOct 27, 2023
Details
- NPI
- 1881466548
- Entity type
- Individual (NPI-1)
- Name
- Staton Omo-Abu
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 26, 2023
- Certification date
- Oct 27, 2023
- Last updated
- Oct 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 374700000X | Technician | – | TX | Yes |
Other names
- Staton Omo-Abu (Former Name)
Practice location
14455 Preston Rd Apt 108Dallas, TX 75254-8540
Phone 512-300-1829
Mailing address
14455 Preston Rd Apt 108Dallas, TX 75254-8540
Phone 512-300-1829
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