Provider Demographics
NPI:1346812971
Name:ABRAMS, CHAD EDWARD
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:EDWARD
Last Name:ABRAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3006 DAWN DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-2879
Mailing Address - Country:US
Mailing Address - Phone:512-966-5883
Mailing Address - Fax:
Practice Address - Street 1:3006 DAWN DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-2879
Practice Address - Country:US
Practice Address - Phone:512-966-5883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX375101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice