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General NPI Number Information
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NPI Number | 1730604448
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Entity Type | Individual
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Provider Name | ABHIRAM JAVVAJI MD
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Gender | Male
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Dates
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Enumeration Date | 08/03/2017
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 1600 W COLLEGE ST STE LL10
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City | GRAPEVINE
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State | TX
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Zip | 76051-3018
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Country | US
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Telephone | 817-912-9230
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Fax |
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Provider Business Mailing Address
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Address Line | 5501 OLD YORK RD
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City | PHILADELPHIA
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State | PA
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Zip | 19141-3018
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MT222762
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | U3555
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 25728
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License Number State | FL
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