Provider Demographics
NPI:1194111781
Name:ABRAHAM, DAWN (DCN, RDN, LD, CHC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:
Credentials:DCN, RDN, LD, CHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4317 GULLS LANDING CIR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-2950
Mailing Address - Country:US
Mailing Address - Phone:832-492-1099
Mailing Address - Fax:
Practice Address - Street 1:4317 GULLS LANDING CIR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-2950
Practice Address - Country:US
Practice Address - Phone:832-492-1099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-09
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT81171133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered