Provider Demographics
NPI:1508041120
Name:ABRAHAM, CILYMOL (CPNP)
Entity Type:Individual
Prefix:MS
First Name:CILYMOL
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 TAUB LOOP
Mailing Address - Street 2:BEN TAUB GENERAL HOSPITAL PHYSCIAN SERVICES ADMIN
Mailing Address - City:HPUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-873-6019
Mailing Address - Fax:713-440-1270
Practice Address - Street 1:1504 TAUB LOOP
Practice Address - Street 2:BEN TAUB GENERAL HOSPITAL PHYSCIAN SERVICES ADMIN
Practice Address - City:HPUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-873-6019
Practice Address - Fax:713-440-1270
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX557833363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics