Active NPI
Liju V Abraham, PHARM.D.
- Pharmacist
- Dallas, TX
National Provider Identifier
1578848917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 56319
- Practice address
- 8915 Harry Hines Blvd
Dallas, TX 75235-1717 - Phone
- (214) 351-3490
- NPI assigned
- Oct 17, 2011
- Last updated
- Jan 12, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH024978 | GA | |
| Pharmacist | 183500000X | 0000034283 | TN | |
| Pharmacist | 183500000X | 56319 | TX | Primary |
Addresses
Primary practice location
8915 Harry Hines Blvd
Dallas, TX 75235-1717
Mailing address
2013 Magic Mantle Dr
The Colony, TX 75056-4237
Phone (423) 326-8727
Other practice location 1
3625 Battlefield Pkwy
Ft Oglethorpe, GA 30742-4001
Phone (706) 866-1839
Other practice location 2
5323 Harry Hines Blvd
Dallas, TX 75390-4001
Phone (214) 633-0299
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH024978 | GA | MD | Pharmacist |
| 0000034283 | TN | MD | Pharmacist |
| 56319 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673481600000",
"number": "1578848917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2013 MAGIC MANTLE DR",
"city": "THE COLONY",
"state": "TX",
"postal_code": "750564237",
"telephone_number": "423-326-8727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8915 HARRY HINES BLVD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752351717",
"telephone_number": "214-351-3490"
}
],
"practiceLocations": [
{
"address_1": "3625 Battlefield Pkwy",
"address_purpose": "LOCATION",
"city": "Ft Oglethorpe",
"state": "GA",
"postal_code": "307424001",
"country_code": "US",
"telephone_number": "706-866-1839",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5323 Harry Hines Blvd",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "753904001",
"country_code": "US",
"telephone_number": "214-633-0299",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ABRAHAM",
"first_name": "LIJU",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-17",
"last_updated": "2023-01-12",
"certification_date": "2023-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH024978",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "0000034283",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "56319",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.