Individual
DERRICK BENJAMIN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3601 4TH ST - STOP 7217, LUBBOCK, TX 79430-7217
(806) 743-2020
(806) 743-1782
Mailing address
3601 4TH ST - STOP 7217, LUBBOCK, TX 79430-7217
(806) 743-2020
(806) 743-1782
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
BP10080217
TX
Other
Enumeration date
05/16/2022
Last updated
05/18/2023
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