Individual
CODY GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1801 N OREGON ST, EL PASO, TX 79902-3524
(915) 521-1200
Mailing address
28 N PALAFOX ST, PENSACOLA, FL 32502-5626
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
871969
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
1108463
TX
Other
Enumeration date
01/13/2023
Last updated
01/23/2023
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