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General NPI Number Information
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NPI Number | 1356736870
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Entity Type | Individual
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Provider Name | BENJAMIN ROSHAN ABRAHAM MD
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Gender | Male
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Dates
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Enumeration Date | 04/01/2015
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Last Update Date | 01/21/2022
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Provider Practice Location Address
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Address Line | 7601 PRESTON RD
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City | PLANO
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State | TX
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Zip | 75024-3214
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Country | US
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Telephone | 214-456-9250
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Fax | 214-456-1240
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Provider Business Mailing Address
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Address Line | 7601 PRESTON RD
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City | PLANO
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State | TX
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Zip | 75024-3214
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Country | US
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Telephone | 214-456-9250
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Fax | 214-456-1240
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | T0682
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2019010691
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License Number State | MO
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