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General NPI Number Information
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NPI Number | 1215569975
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Entity Type | Organization
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Legal Business Name | SIMI ABRAHAM PLLC
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Dates
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Enumeration Date | 02/10/2020
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Last Update Date | 02/10/2020
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Provider Practice Location Address
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Address Line | 4541 N JOSEY LN STE 210
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City | CARROLLTON
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State | TX
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Zip | 75010-4780
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Country | US
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Telephone | 469-669-0222
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Fax | 469-669-0221
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Provider Business Mailing Address
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Address Line | 2101 IRONSIDE DR
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City | LEWISVILLE
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State | TX
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Zip | 75056-4215
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Country | US
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Telephone | 423-240-4713
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. SIMI ABRAHAM
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Credential | DDS
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Telephone | 423-240-4713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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