MEDICARE: DR. ANN ABRAHAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	L5210	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437152048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANN ABRAHAM MD

Provider Business Mailing Address
First Line	:	12221 N MO PAC EXPY
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78758-2401
Country	:	US
Telephone Number	:	512-901-4026
Fax Number	:	512-901-3940

Provider Business Practice Location Address
First Line	:	2400 CEDAR BEND DR.
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78758-2483
Country	:	US
Telephone Number	:	512-901-4026
Fax Number	:	512-901-3940

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	02/25/2013

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