Organization
AUDREY L. GRAHAM, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARGARET KANNADY (BILLING)
(972) 613-5379
Entity
Organization
Contact information
Practice address
3310 LIVE OAK ST, 400, DALLAS, TX 75204-6147
(214) 823-6500
(214) 823-6816
Mailing address
3310 LIVE OAK ST, 400, DALLAS, TX 75204-6147
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
H7060
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141549901
—
TX
Enumeration date
10/09/2007
Last updated
06/26/2009
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