Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 726467 | TX |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 726767 | TX |
NPI | 1003232018 |
---|---|
Provider Name | Mrs. Soney Abraham |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75390-7208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2014 |
Last Update Date | 16/09/2014 |