Olive Branch Pediatrics, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

OLIVE BRANCH PEDIATRICS, PLLC

Practice address

3105 W 15TH St Ste D
Plano, TX 75075-7700

Phone

(214) 674-9189

NPI assigned

May 18, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Jaeon Abraham, MDNPI 1043638885

Title

Manager

Phone

(972) 867-2869

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Jaeon Abraham, M.D.

  • Pediatrics Physician
  • Plano, TX
  • NPI 1043638885
  NPD Authorized official

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514592000000",
    "number": "1659808723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 W 15TH ST STE D",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757700",
            "telephone_number": "972-867-2869",
            "fax_number": "972-964-5219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 W 15TH ST STE D",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757700",
            "telephone_number": "214-674-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE BRANCH PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-18",
        "last_updated": "2017-12-30",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "JAEON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "972-867-2869",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summer Oleson
• Kathleen Oliva, PT, DPT
• Antonio R. Olivarez, LMT
• Julizza E Olivarez
• Olive Branch Group LLC
• Hosea Oliver, RA
• Federico Oliveri, M.D.
• Courtney Ann Olivo, MS-SLP
• Olufunke Oloyede, LVN
• Anna Lynn Olson, OTR

• Pediatrics Physician in Plano, TX
• Providers in Plano, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.