Provider Demographics
NPI:1972042372
Name:GRAHAM HEALTHCARE PLLC
Entity Type:Organization
Organization Name:GRAHAM HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:GARRETT
Authorized Official - Last Name:PURDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-282-2513
Mailing Address - Street 1:1005 STATE HIGHWAY 16 S
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:TX
Mailing Address - Zip Code:76450-3835
Mailing Address - Country:US
Mailing Address - Phone:940-282-2513
Mailing Address - Fax:940-521-9139
Practice Address - Street 1:1005 STATE HIGHWAY 16 S
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:TX
Practice Address - Zip Code:76450-3835
Practice Address - Country:US
Practice Address - Phone:940-282-2513
Practice Address - Fax:940-521-9139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4004207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty