Provider Demographics
NPI:1669450797
Name:GRAHAM, JAMES L (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:708 HILL COUNTRY DR
Mailing Address - Street 2:300A
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-6070
Mailing Address - Country:US
Mailing Address - Phone:830-896-4433
Mailing Address - Fax:830-896-4434
Practice Address - Street 1:708 HILL COUNTRY DR
Practice Address - Street 2:300A
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-6070
Practice Address - Country:US
Practice Address - Phone:830-896-4433
Practice Address - Fax:830-896-4434
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG7220207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00FP42Medicare ID - Type Unspecified
TXC16242Medicare UPIN