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General NPI Number Information
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NPI Number | 1952704256
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Entity Type | Individual
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Provider Name | GEOFFREY BRIAN ABRAHAM O.D.
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Gender | Male
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Dates
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Enumeration Date | 09/30/2014
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 2000 NEWPOINT PKWY STE 100
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-5582
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Country | US
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Telephone | 678-892-3773
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Fax |
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Provider Business Mailing Address
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Address Line | 4030 N CENTRAL EXPY APT 332
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City | DALLAS
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State | TX
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Zip | 75204-3248
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Country | US
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Telephone | 617-304-6978
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 8541T
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License Number State | TX
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