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General NPI Number Information
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NPI Number | 1851432025
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Entity Type | Individual
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Provider Name | ELIZABETH RACHEL ABRAHAM PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6161 HARRY HINES BLVD SUITE 100
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City | DALLAS
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State | TX
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Zip | 75235-5387
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Country | US
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Telephone | 214-267-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 9116 DILLON TRAIL
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City | IRVING
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State | TX
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Zip | 75063
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Country | US
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Telephone | 214-683-1454
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | TEMP LICENCE
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License Number State | TX
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