Provider Demographics
NPI:1962939058
Name:ABRAHAM, SHINOY I (DMD)
Entity type:Individual
Prefix:DR
First Name:SHINOY
Middle Name:I
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:SHINOY
Other - Middle Name:
Other - Last Name:ABRAHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3607 OLD SPANISH TRL STE G
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-2312
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3607 OLD SPANISH TRL STE G
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-2312
Practice Address - Country:US
Practice Address - Phone:281-747-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-19
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32849122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist