Provider Demographics
NPI:1932503562
Name:ABRAHAM, NEIL (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 E TRANT RD APT 303
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78363-9643
Mailing Address - Country:US
Mailing Address - Phone:409-594-8196
Mailing Address - Fax:
Practice Address - Street 1:922 E KING AVE
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-5867
Practice Address - Country:US
Practice Address - Phone:361-221-9714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-10
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55436183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist