Individual
GARY PETER GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1305 W JEFFERSON ST STE 120, WAXAHACHIE, TX 75165-2251
(972) 923-1457
Mailing address
1305 W JEFFERSON ST STE 120, WAXAHACHIE, TX 75165-2251
(972) 923-1457
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
P5810
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3275828-01
—
TX
05
—
3275828-02
—
TX
Enumeration date
05/19/2008
Last updated
05/13/2014
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