Provider Demographics
NPI:1851432025
Name:ABRAHAM, ELIZABETH RACHEL (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:RACHEL
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:ELZA
Other - Middle Name:RACHEL
Other - Last Name:ABRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9116 DILLON TRAIL
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063
Mailing Address - Country:US
Mailing Address - Phone:214-683-1454
Mailing Address - Fax:
Practice Address - Street 1:6161 HARRY HINES BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-5387
Practice Address - Country:US
Practice Address - Phone:214-267-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTEMP LICENCE363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant