Provider Demographics
NPI:1003409160
Name:ABRAHAMS, MEKAYLA AMANDA
Entity type:Individual
Prefix:
First Name:MEKAYLA
Middle Name:AMANDA
Last Name:ABRAHAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 THREADNEEDLE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-2919
Mailing Address - Country:US
Mailing Address - Phone:903-207-7062
Mailing Address - Fax:
Practice Address - Street 1:900 THREADNEEDLE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2919
Practice Address - Country:US
Practice Address - Phone:903-207-7062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-18
Last Update Date:2025-07-05
Deactivation Date:2022-03-02
Deactivation Code:
Reactivation Date:2025-06-18
Provider Licenses
StateLicense IDTaxonomies
TX1003409160225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist