Provider Demographics
NPI:1831388057
Name:ABRAHAM, MATTHEW (CRT/RCP)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:CRT/RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9299 KIRBY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2520
Mailing Address - Country:US
Mailing Address - Phone:713-578-2457
Mailing Address - Fax:
Practice Address - Street 1:9299 KIRBY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2520
Practice Address - Country:US
Practice Address - Phone:713-578-2457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX629202278H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1273393-01Medicaid
TX1273393-04Medicaid
TX1273393-03Medicaid