Provider Demographics
NPI:1578848917
Name:ABRAHAM, LIJU V (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LIJU
Middle Name:V
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 MAGIC MANTLE DR
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-4237
Mailing Address - Country:US
Mailing Address - Phone:423-326-8727
Mailing Address - Fax:
Practice Address - Street 1:8915 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-1717
Practice Address - Country:US
Practice Address - Phone:214-351-3490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH024978183500000X
TN0000034283183500000X
TX56319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist