Individual
CAROLE M. GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
5201 HARRY HINES BLVD, WISH TUBAL CLINIC, DALLAS, TX 75235-7708
(214) 590-5306
(214) 590-2798
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
657335
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163728202
—
TX
05
—
163728203
—
TX
05
—
163728204
—
TX
05
—
163728205
—
TX
05
—
163728206
—
TX
05
—
163728207
—
TX
05
—
163728208
—
TX
05
—
163728209
—
TX
05
—
163728210
—
TX
05
—
163728211
—
TX
01
—
8N4796
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/28/2006
Last updated
03/06/2009
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