Provider Demographics
NPI:1780703652
Name:GRAHAM, PATRICIA L (PA)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:L
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:720 COOL SPRINGS BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2626
Mailing Address - Country:US
Mailing Address - Phone:615-778-4066
Mailing Address - Fax:615-778-9114
Practice Address - Street 1:4060 SANDSHELL DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76137-2422
Practice Address - Country:US
Practice Address - Phone:615-778-4066
Practice Address - Fax:615-778-9114
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2011-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA00165363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant