Active NPI
Surya Abraham
- Psychiatric/Mental Health Nurse Practitioner
- Missouri City, TX
National Provider Identifier
1780105312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- AP133723
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F03170299 | Other | TX | FAMILY 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| F03170299 | TX | MD | Family Nurse Practitioner |
| AP133723 | TX | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Behavioral of Texas PA | Current | 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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Missouri City, TX
- NPI 1861053514
Psychiatric/Mental Health
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.