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General NPI Number Information
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NPI Number | 1689741340
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Entity Type | Individual
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Provider Name | ALEYAMMA ABRAHAM M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 09/02/2016
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Provider Practice Location Address
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Address Line | 5875 N MAJOR DR
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City | BEAUMONT
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State | TX
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Zip | 77713-9034
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Country | US
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Telephone | 409-892-2262
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Fax | 409-892-3336
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Provider Business Mailing Address
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Address Line | 6350 CLAYBOURN DR
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City | BEAUMONT
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State | TX
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Zip | 77706-7238
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Country | US
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Telephone | 409-466-4424
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | L5209
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License Number State | TX
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