Provider Demographics
NPI:1043296981
Name:ANDREW PAUL ABRAHAM PT PA
Entity Type:Organization
Organization Name:ANDREW PAUL ABRAHAM PT PA
Other - Org Name:SEARCY PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:P
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:501-268-2513
Mailing Address - Street 1:801 W BEEBE CAPPS EXPY
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-6353
Mailing Address - Country:US
Mailing Address - Phone:501-268-2513
Mailing Address - Fax:501-279-1328
Practice Address - Street 1:801 W BEEBE CAPPS EXPY
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-6353
Practice Address - Country:US
Practice Address - Phone:501-268-2513
Practice Address - Fax:501-279-1328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5F407OtherBLUE CROSS BLUE SHIELD
AR157701742Medicaid
AR5F407OtherBLUE CROSS BLUE SHIELD