# 4500 GULFWAY MEDICAL MANAGEMENT PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326100439
- **Authorized official:** ISAM NAZMI ANABTAWI MD (DOCTOR)
- **Authorized official phone:** (409) 982-5110

## Contact information

- **Practice address:** 4500 GULFWAY DRIVE, PORT ARTHUR, TX 77642
- **Practice address phone:** (409) 982-5110
- **Practice address fax:** (409) 982-8196
- **Mailing address:** PO BOX 3756, PORT ARTHUR, TX 77643
- **Mailing address phone:** (409) 982-5110
- **Mailing address fax:** (409) 982-8196

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | D5588 | TX | Yes |

## Other

- **Enumeration date:** 12/14/2006
- **Last updated:** 10/29/2007