Provider Demographics
NPI:1104837210
Name:GRAHAM, LOYD ALTON (MD)
Entity Type:Individual
Prefix:DR
First Name:LOYD
Middle Name:ALTON
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 MEMORIAL BLVD
Mailing Address - Street 2:VA HOSPITAL
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-5768
Mailing Address - Country:US
Mailing Address - Phone:830-896-2020
Mailing Address - Fax:
Practice Address - Street 1:664 LOWER TURTLE CREEK RD
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-8096
Practice Address - Country:US
Practice Address - Phone:830-257-5487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5104207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine