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General NPI Number Information
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NPI Number | 1639559784
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Entity Type | Individual
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Provider Name | MABEL ABRAHAM
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Gender | Female
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Dates
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Enumeration Date | 06/04/2015
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Last Update Date | 06/04/2015
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Provider Practice Location Address
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Address Line | 1113 ALMA ST
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City | TOMBALL
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State | TX
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Zip | 77375-4518
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Country | US
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Telephone | 281-351-0005
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Fax |
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Provider Business Mailing Address
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Address Line | 8402 OAK KNOT CT
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City | SPRING
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State | TX
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Zip | 77389-4009
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Country | US
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30923
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License Number State | TX
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