NPI 1710644125 · live from the CMS NPI Registry
Jesstin Abraham, PT, DPT
Physical Therapist in Southlake, TX. National Provider Identifier 1710644125, active.
NPI record
| NPI | 1710644125 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physical Therapist 225100000X |
| Practice location | 1959 W Southlake Blvd Ste 180, Southlake, TX 76092 |
| Practice phone | 330-423-3115 |
| Mailing address | 3408 Willowcreek Dr, Sunnyvale, TX 75182 |
| Enumerated | November 19, 2021 |
| Last updated | August 19, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Therapist primary | 225100000X | 1355306 (TX) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.