Provider Demographics
NPI:1972581932
Name:MCGRAEL, J PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:J
Middle Name:PATRICK
Last Name:MCGRAEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:J
Other - Middle Name:PATRICK
Other - Last Name:MCGRAEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5012 S US HIGHWAY 75
Mailing Address - Street 2:SUITE 215
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-4587
Mailing Address - Country:US
Mailing Address - Phone:903-548-0011
Mailing Address - Fax:903-548-0020
Practice Address - Street 1:5012 S US HIGHWAY 75
Practice Address - Street 2:SUITE 215
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-4587
Practice Address - Country:US
Practice Address - Phone:903-548-0011
Practice Address - Fax:903-548-0020
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3599208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B24746Medicare UPIN
TX8F1771Medicare ID - Type Unspecified