Manoj Abraham, O.D.
Optometrist in Southlake, TX. Individual provider (NPI-1).
NPI number1952500159
StatusActive
Last updated in NPPESDec 2, 2016
Details
- NPI
- 1952500159
- Entity type
- Individual (NPI-1)
- Name
- Manoj Abraham
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 17, 2007
- Last updated
- Dec 2, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - OPTOMETRY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 8563T | TX | Yes |
| 152W00000X | Optometrist | 046009950 | IL |
Practice location
1251 E Southlake BlvdSuite 331
Southlake, TX 76092-6478
Phone 817-310-0289
Mailing address
1505 Stone DrCarrollton, TX 75010-1147
Phone 630-452-6290
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 42 Optometrist providers in Southlake · All 2,154 providers in Southlake
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