Provider Demographics
NPI:1033593983
Name:ABRAHAM, SHIBY (RPH)
Entity Type:Individual
Prefix:
First Name:SHIBY
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 S CENTRAL EXPY STE 200
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-4345
Mailing Address - Country:US
Mailing Address - Phone:972-548-1088
Mailing Address - Fax:972-548-1668
Practice Address - Street 1:3001 S CENTRAL EXPY STE 200
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-4345
Practice Address - Country:US
Practice Address - Phone:972-548-1088
Practice Address - Fax:972-548-1668
Is Sole Proprietor?:No
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist