MEDICARE: DR. ERIN S ABRAHAM OD

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	152W00000X	Optometrist	10856T	TX

General Provider Information

NPI Number	:	1598440505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIN S ABRAHAM OD

Provider Business Mailing Address
First Line	:	1201 ELM ST STE LL20
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75270-2029
Country	:	US
Telephone Number	:	214-901-2197
Fax Number	:	214-651-1000

Provider Business Practice Location Address
First Line	:	1201 ELM ST STE LL20
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75270-2029
Country	:	US
Telephone Number	:	214-651-1000
Fax Number	:	214-651-1000

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

Provider Enumeration Date	:	06/19/2023
Last Update Date	:	08/06/2024

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