Provider Demographics
NPI:1861472961
Name:GRAHAM, CHRISTOPHER W (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:W
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7909 FREDERICKSBURG RD
Mailing Address - Street 2:SUITE# 110
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3425
Mailing Address - Country:US
Mailing Address - Phone:210-614-4544
Mailing Address - Fax:210-582-5522
Practice Address - Street 1:255 E SONTERRA BLVD
Practice Address - Street 2:SUITE# 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4075
Practice Address - Country:US
Practice Address - Phone:210-581-0376
Practice Address - Fax:210-581-0382
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2009-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ6974208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX096689701Medicaid
TX82Z705Medicare ID - Type Unspecified
TX096689701Medicaid