Individual
PHILLIP MADSEN GRAEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4780 N JOSEY LN, CARROLLTON, TX 75010-4615
(972) 492-1334
(972) 492-5174
Mailing address
4780 N JOSEY LN, CARROLLTON, TX 75010-4615
(972) 492-1334
(972) 492-5174
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G9967
TX
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
G9967
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122271305
—
TX
01
—
6484850003
MEDICARE NSC - EFFECT. 02/01/2011
TX
01
—
8CR155
BCBS TX 02/01/11
TX
01
—
8F4981
BLUE CROSS BLUE SHIELD
TX
01
—
P00913367
MEDICARE RAILROAD - EFFECT. 02/01/2011
TX
01
—
TXB117513
MEDICARE PART B - EFFECT 02/01/2011
TX
Enumeration date
10/12/2006
Last updated
02/01/2017
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