Provider Demographics
NPI:1477896751
Name:GRAHAM PAIN MANAGEMENT P.A.
Entity Type:Organization
Organization Name:GRAHAM PAIN MANAGEMENT P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-772-4539
Mailing Address - Street 1:PO BOX 794948
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75379-4948
Mailing Address - Country:US
Mailing Address - Phone:972-488-8926
Mailing Address - Fax:972-772-8099
Practice Address - Street 1:17480 DALLAS PKWY STE 125
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-7354
Practice Address - Country:US
Practice Address - Phone:972-488-8926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-04
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty