Provider Demographics
NPI:1447460910
Name:ABRAMS, JAMELIA ENIECE (DPM)
Entity type:Individual
Prefix:
First Name:JAMELIA
Middle Name:ENIECE
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2776 BAY SHORE LN
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-7255
Mailing Address - Country:US
Mailing Address - Phone:817-539-0588
Mailing Address - Fax:
Practice Address - Street 1:2776 BAY SHORE LN
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75054-7255
Practice Address - Country:US
Practice Address - Phone:817-539-0588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002169213ES0103X
TX1848213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX193700508Medicaid
TXP01332015OtherRAILROAD MEDICARE
TX193700509Medicaid
TX193700504Medicaid
TX193700510Medicaid
TX193700510Medicaid
TX277709YPREMedicare PIN
TX277709YR1KMedicare UPIN
TX277709YPT7Medicare PIN