Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | L3889 | TX |
NPI | 1326152141 |
---|---|
Provider Name | Dr. Judith Elaine Graham |
First Address | Dumas, TX 79029-0394 |
Second Address | Dumas, TX 79029-3806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 02/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
055996 | FIRSTCARE (01) | TX |
154264903 | (05) | TX |
8G5570 | BCBS (01) | TX |
H71733 | (02) | TX |
TXB158040 | MEDICARE (01) | TX |