AUDREY L. GRAHAM, MD, PA
Medical Practice at Live Oak St, Dallas, TX

License number
Texas H7060
Category
Medical Practice
Type
Specialist
Owner
Name: MARGARET KANNADY
Title: BILLING
Phone: (972) 613-5379
Address
Address
3310 Live Oak St, Dallas, TX 75204
National Provider ID: 1518155258
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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AUDREY L. GRAHAM M.D., PA

Dallas, TX

Doing business as:
Audrey L. Graham M.D., PA
Registration:
Aug 28, 2000
Addresses:
3100 Swiss Ave, Dallas, TX 75204 (Mailing)
3310 Live Oak St, Dallas, TX 75204
State ID:
0082168103
Business type:
Professional Association
President , Secretary , Director , Member:
Audrey L. Graham (President , Secretary , Director , Member)
Agent:
Audrey L Graham,3100 Swiss Ave, Dallas, TX 75204 (Physical)
TIN:
32035990962

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