Provider Demographics
NPI:1417215757
Name:ABRAHAM, MERLIN JOICE (MD)
Entity Type:Individual
Prefix:DR
First Name:MERLIN
Middle Name:JOICE
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MERLIN
Other - Middle Name:JOICE
Other - Last Name:JOHNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBCHB
Mailing Address - Street 1:6210 E HIGHWAY 290 STE 420
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1142
Mailing Address - Country:US
Mailing Address - Phone:512-483-9596
Mailing Address - Fax:
Practice Address - Street 1:15803 WINDERMERE DR
Practice Address - Street 2:SUITE 103
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2402
Practice Address - Country:US
Practice Address - Phone:512-989-2680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ2718207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX446946YKXVOtherARC TRAVIS MEDICARE
TX446946YKXYOtherARC ROT MEDICARE