Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | N3694 | TX |
NPI | 1023162732 |
---|---|
Provider Name | Richard Marshall Graves |
First Address | Sulphur Springs, TX 75483-1367 |
Second Address | Sulphur Springs, TX 75482-2138 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 06/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
205719203 | (05) | TX |