Provider Demographics
NPI:1982931937
Name:ABRAHAM, LEEJIA MARY (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:LEEJIA
Middle Name:MARY
Last Name:ABRAHAM
Suffix:
Gender:F
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 1:6515 ABRAMS RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-7207
Mailing Address - Country:US
Mailing Address - Phone:214-341-0861
Mailing Address - Fax:214-341-4314
Practice Address - Street 1:6515 ABRAMS RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-7207
Practice Address - Country:US
Practice Address - Phone:214-341-0861
Practice Address - Fax:214-341-4314
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-07
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist