Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | L6404 | TX |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | L6404 | TX |
NPI | 1215935820 |
---|---|
Provider Name | Dr. Robert D Graham II |
First Address | Austin, TX 78758-2647 |
Second Address | Austin, TX 78758 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2005 |
Last Update Date | 27/08/2018 |