Glen R. Abraham, D.D.S.

Individual provider Active NPI General Practice Dentistry · Spring, TX

NPI 1356562482 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1356562482
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
18655 (TX)
Practice address
4740 Spring Cypress Rd Ste E
Spring, TX 77379-3447
Phone
(281) 374-7100
Fax
(281) 374-8425
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
18655TXMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 18655 TX Yes

Addresses

Primary practice location

4740 Spring Cypress Rd Ste E
Spring, TX 77379-3447

Mailing address

4740 Spring Cypress Rd Ste E
Spring, TX 77379-3447
Phone (281) 374-7100

Other providers in Spring, TX

All providers in Spring, TX · General Practice Dentistry in Texas

Sources for this page

Verify at the official NPI Registry.