Individual
MR. JORDAN BRETT GRAFFAGNINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSA, CSFA
Contact information
Practice address
9325 PHELAN BLVD, BEAUMONT, TX 77706-5122
(409) 554-1138
Mailing address
9325 PHELAN BLVD, BEAUMONT, TX 77706-5122
(409) 554-1138
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
SA00483
TX
246ZC0007X
Surgical Assistant
Primary
SA00483
TX
246ZS0410X
Surgical Technologist
136982
TX
Other
Enumeration date
08/02/2012
Last updated
11/23/2021
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