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General NPI Number Information
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NPI Number | 1578848917
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Entity Type | Individual
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Provider Name | LIJU V ABRAHAM PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 10/17/2011
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 8915 HARRY HINES BLVD
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City | DALLAS
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State | TX
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Zip | 75235-1717
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Country | US
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Telephone | 214-351-3490
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Fax |
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Provider Business Mailing Address
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Address Line | 2013 MAGIC MANTLE DR
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City | THE COLONY
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State | TX
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Zip | 75056-4237
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Country | US
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Telephone | 423-326-8727
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH024978
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0000034283
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 56319
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License Number State | TX
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