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NPI Code Detail

MEDICARE: MR. ABRAHAM MINJARES LPC

MEDICARE: MR. ABRAHAM MINJARES LPC
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
1101YP2500XProfessional Counselor14403TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
183320LOTHERTXBCBS

General Provider Information

NPI Number : 1861548745
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ABRAHAM MINJARES LPC
Provider Business Mailing Address
First Line : 1430 COLLIER ST
Second Line :
City : AUSTIN
State : TX
Zip : 78704-2911
Country : US
Telephone Number : 512-445-7787
Fax Number : 512-440-4059
Provider Business Practice Location Address
First Line : 1430 COLLIER ST
Second Line :
City : AUSTIN
State : TX
Zip : 78704-2911
Country : US
Telephone Number : 512-445-7783
Fax Number : 512-440-4081
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2007
Last Update Date : 07/08/2007

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