MEDICARE: JAIMSON ABRAHAM

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	183500000X	Pharmacist	52468	TX

General Provider Information

NPI Number	:	1942655972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIMSON ABRAHAM

Provider Business Mailing Address
First Line	:	6065 HILLCROFT ST STE 109
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-1005
Country	:	US
Telephone Number	:	713-270-7771
Fax Number	:	713-988-3227

Provider Business Practice Location Address
First Line	:	6065 HILLCROFT ST STE 109
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-1005
Country	:	US
Telephone Number	:	713-270-7771
Fax Number	:	713-988-3227

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

Provider Enumeration Date	:	04/27/2016
Last Update Date	:	04/27/2016

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Directions to “ JAIMSON ABRAHAM ” Practice Location

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