Provider Demographics
NPI:1982206256
Name:ABRAHAM, EMIL SUNNY (PHARM D)
Entity Type:Individual
Prefix:
First Name:EMIL
Middle Name:SUNNY
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 1:5400 WORLEY DR
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-3854
Mailing Address - Country:US
Mailing Address - Phone:469-494-2546
Mailing Address - Fax:
Practice Address - Street 1:782 E INTERSTATE 30
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-5503
Practice Address - Country:US
Practice Address - Phone:972-771-8612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63974183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist