Provider Demographics
NPI:1972300515
Name:ABRAHAM, FAITH GRACE (OD)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:GRACE
Last Name:ABRAHAM
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 W BRAKER LN APT 205
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-1207
Mailing Address - Country:US
Mailing Address - Phone:954-254-3926
Mailing Address - Fax:
Practice Address - Street 1:10601 PECAN PARK BLVD STE 201
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1325
Practice Address - Country:US
Practice Address - Phone:512-401-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-01
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11324152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist