Provider Demographics
NPI:1205521655
Name:ABRAHAM, BRICE BERNARDO
Entity type:Individual
Prefix:
First Name:BRICE
Middle Name:BERNARDO
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5621 ALDINE BENDER RD APT 3714
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77032-4543
Mailing Address - Country:US
Mailing Address - Phone:832-963-5037
Mailing Address - Fax:
Practice Address - Street 1:5621 ALDINE BENDER RD APT 3714
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77032-4543
Practice Address - Country:US
Practice Address - Phone:832-963-5037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle