Provider Demographics
NPI:1194184234
Name:GRAHAM, DAVID (CNIM)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CENTRAL EXPY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-6772
Mailing Address - Country:US
Mailing Address - Phone:888-344-2947
Mailing Address - Fax:888-694-2947
Practice Address - Street 1:500 CENTRAL EXPY
Practice Address - Street 2:SUITE 202
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-6772
Practice Address - Country:US
Practice Address - Phone:888-344-2947
Practice Address - Fax:888-694-2947
Is Sole Proprietor?:No
Enumeration Date:2016-02-17
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic