Ayodele Abraham MD PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

M9770 Issued in TX

Legal business name

AYODELE ABRAHAM MD PLLC

Practice address

800 Kirnwood Dr
Desoto, TX 75115-2000

Phone

(972) 632-0030

NPI assigned

Dec 23, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ayodele Abraham, MDNPI 1437378999

Title

Psychiatrist/Owner

Phone

(972) 632-0030

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ayodele A Abraham, M.D.

  • Child & Adolescent Psychiatry Physician
  • Vernon, TX
  • NPI 1437378999
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450828800000",
    "number": "1306201900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7505 FOREST BEND DR",
            "city": "PARKER",
            "state": "TX",
            "postal_code": "750026948",
            "telephone_number": "972-632-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 KIRNWOOD DR",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152000",
            "telephone_number": "972-632-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AYODELE ABRAHAM MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-23",
        "last_updated": "2015-12-23",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "AYODELE",
        "authorized_official_title_or_position": "PSYCHIATRIST/OWNER",
        "authorized_official_telephone_number": "972-632-0030",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "M9770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Desoto, TX
• Providers in Desoto, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.