Active NPI
Jiju Mylackal Abraham, MPT
- Physical Therapist
- Houston, TX
National Provider Identifier
1871701052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1154710
- Practice address
- 2939 Woodland Park Dr
Houston, TX 77082-2687 - Phone
- (281) 870-9100
- NPI assigned
- May 19, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1154710 | TX | Primary |
Addresses
Primary practice location
2939 Woodland Park Dr
Houston, TX 77082-2687
Mailing address
1515 Waterwood CT
Missouri City, TX 77459-1725
Phone (713) 443-4681
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1154710 | TX | MD | Physical Therapist |
Interoperability endpoints
- jiju.abraham.1@13131.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871701052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 WATERWOOD CT",
"city": "MISSOURI CITY",
"state": "TX",
"postal_code": "774591725",
"telephone_number": "713-443-4681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2939 WOODLAND PARK DR",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770822687",
"telephone_number": "281-870-9100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABRAHAM",
"first_name": "JIJU",
"middle_name": "MYLACKAL",
"name_prefix": "Mr.",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1154710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.