Provider Demographics
NPI:1740742501
Name:ABRAHAMS, CIDDET RICARDO JR (DNP, RN, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:CIDDET
Middle Name:RICARDO
Last Name:ABRAHAMS
Suffix:JR
Gender:M
Credentials:DNP, RN, PMHNP-BC
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11119 BADGER PEAK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-1812
Mailing Address - Country:US
Mailing Address - Phone:210-887-5211
Mailing Address - Fax:
Practice Address - Street 1:8026 FLOYD CURL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3915
Practice Address - Country:US
Practice Address - Phone:210-887-5211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140976363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health