Provider Demographics
NPI:1417350661
Name:ABRAHAMSON, NAOMI
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:ABRAHAMSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7227 FANNIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4800
Mailing Address - Country:US
Mailing Address - Phone:877-246-9104
Mailing Address - Fax:
Practice Address - Street 1:7227 FANNIN ST STE 103
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4848
Practice Address - Country:US
Practice Address - Phone:877-246-9104
Practice Address - Fax:888-963-8103
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-02
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY059761183500000X
NJ28RI03791600183500000X
LAPST.022479183500000X
MI5302046550183500000X
WVRP0010455183500000X
KS1-107848183500000X
ARPD14451183500000X
NE16028183500000X
ORRPH-0017018183500000X
AL20845183500000X
KY020599183500000X
VA202217506183500000X
OK18347183500000X
TX57525183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist