Organization
INVICTA HEALTHCARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHINY MARY ABRAHAM MD (CEO)
(216) 469-5575
Entity
Organization
Contact information
Practice address
9545 N BEACH ST STE 101, FORT WORTH, TX 76244-6470
(817) 381-9650
(817) 585-5836
Mailing address
771 E SOUTHLAKE BLVD STE 101, SOUTHLAKE, TX 76092-1483
(216) 469-5516
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Q1450
TX
2084P0800X
Psychiatry Physician
Q0601
TX
2084P0800X
Psychiatry Physician
Q1450
TX
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
Primary
Q1450
TX
208VP0000X
Pain Medicine Physician
—
—
Other
Enumeration date
05/04/2016
Last updated
02/04/2025
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