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NPI Code Detail

MEDICARE: LIDA S ABRAHAM

MEDICARE: LIDA S ABRAHAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist56394TX

General Provider Information

NPI Number : 1205553302
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIDA S ABRAHAM
Provider Business Mailing Address
First Line : 1621 S MASON RD
Second Line :
City : KATY
State : TX
Zip : 77450-4564
Country : US
Telephone Number : 281-599-0958
Fax Number :
Provider Business Practice Location Address
First Line : 1621 S MASON RD
Second Line :
City : KATY
State : TX
Zip : 77450-4564
Country : US
Telephone Number : 281-599-0958
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2022
Last Update Date : 01/12/2026

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Directions to “ LIDA S ABRAHAM ” Practice Location

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