Doctor Name: | DR. ABU ABRAHAM JOSEPH |
NPI Number: | 1033477971 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | BP10043992 |
Business Practice Address: | 1513 Choctaw Dr Mesquite, TX - 751491867 |
Business Phone Number: | 4696930632 |
Business Fax Number: | |
Mailing Address: | 1513 Choctaw Dr, MESQUITE |
State: | TX |
Postal Code: | 751491867 |
Phone Number: | 4696930632 |
Fax Number: | |
NPI Enumeration Date: | 04/29/2012 |
NPI Last Update Date: | 09/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | BP10043992 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |