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Individual

DR. SUZANNE CAROL GRAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3601 4TH ST, 1A115, LUBBOCK, TX 79430-0002
(806) 743-2155
(806) 743-2117
Mailing address
PO BOX 5865, LUBBOCK, TX 79408-5865
(806) 743-2898
(806) 743-3596

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
H2131
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
52423
PRESBYTERIAN COMMERCIAL
NM
05
52423
NM
01
80815Z
HMO BLUE
TX
01
82P193
BLUE CROSS & BLUE SHEILD
TX
01
A077
TRIWEST
05
V9653
NM
Enumeration date
05/24/2005
Last updated
07/12/2007
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