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Individual

CHESTER F GRAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1105 CENTRAL EXPY N, SUITE 360, ALLEN, TX 75013-6103
(214) 691-1902
(214) 987-1845
Mailing address
3600 GASTON AVE, SUITE 1205, DALLAS, TX 75246-1800
(214) 692-8262
(214) 696-4190

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
H9214
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
105340701
TX
05
105340702
TX
01
340016186
RRMCR OTHER
TX
01
340016191
RRMCR
TX
01
80420X
BCBS PROVIDER ID
Enumeration date
05/26/2006
Last updated
01/31/2017
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