MEDICARE: JOEL ABRAHAM PT, DPT

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
1	225100000X	Physical Therapist	1305012	TX

General Provider Information

NPI Number	:	1306582028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEL ABRAHAM PT, DPT

Provider Business Mailing Address
First Line	:	11908 CEDAR CREEK DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-1635
Country	:	US
Telephone Number	:	832-677-4757
Fax Number	:

Provider Business Practice Location Address
First Line	:	5505 WEST LOOP S
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-2206
Country	:	US
Telephone Number	:	713-441-8400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2022
Last Update Date	:	05/05/2022

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