Provider Demographics
NPI:1255471918
Name:ABRAMSON, EDRA SIMONE (MD)
Entity Type:Individual
Prefix:DR
First Name:EDRA
Middle Name:SIMONE
Last Name:ABRAMSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8220 WALNUT HILL LN
Mailing Address - Street 2:SUITE 416
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4430
Mailing Address - Country:US
Mailing Address - Phone:214-369-5884
Mailing Address - Fax:214-369-5887
Practice Address - Street 1:8220 WALNUT HILL LN
Practice Address - Street 2:SUITE 416
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4430
Practice Address - Country:US
Practice Address - Phone:214-369-5884
Practice Address - Fax:214-369-5887
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3949207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84Z271Medicare ID - Type Unspecified
G26115Medicare UPIN