Individual provider Active NPI

Surya Abraham

  • Psychiatric/Mental Health Nurse Practitioner
  • Missouri City, TX
National Provider Identifier
1780105312
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP133723 Issued in TX
Practice address
3634 Glenn Lakes LN Ste 170
Missouri City, TX 77459-4045
Phone
(281) 606-0622
Fax
(281) 476-6454
NPI assigned
Jul 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP133723 TX Primary
Family Nurse Practitioner 363LF0000X F03170299 TX

Addresses

Primary practice location

3634 Glenn Lakes LN Ste 170
Missouri City, TX 77459-4045

Mailing address

6140 Highway 6 Ste 75
Missouri City, TX 77459-3802
Phone (281) 606-0622

Other identifiers 1

IdentifierTypeStateIssuer
F03170299OtherTXFAMILY NURSE PRACTITIONER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211002430 TX Practitioner - Nurse Practitioner 8224564406 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F03170299TXMDFamily Nurse Practitioner
AP133723TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Behavioral of Texas PA CurrentSince Oct 6, 2024 Accepting new patients
Solace Management LC Psychiatric/Mental Health Past Accepting new patients

Locations

22 Prestige Cir
Ste 200
Allen, TX 75002
Phone (214) 383-3200

550 Westcott St
Ste 520
Houston, TX 77007
Phone (713) 864-6694

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1780105312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 HIGHWAY 6 STE 75",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774593802",
            "telephone_number": "281-606-0622",
            "fax_number": "281-476-6454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3634 GLENN LAKES LN STE 170",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594045",
            "telephone_number": "281-606-0622",
            "fax_number": "281-476-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "SURYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-05",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP133723",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F03170299",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY NURSE PRACTITIONER",
            "identifier": "F03170299",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

Verify at the official NPI Registry.