Graham, Bradley Scott

Graham, Bradley Scott is an individual health care provider with primary practice located at 1367 Dominion Plaza , Tyler TX 75703-1013. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Graham, Bradley Scott can be contacted via phone (903) 534-6200.

Contact Information

Primary practice address
1367 Dominion Plaza Tyler TX 75703-1013
Phone: (903) 534-6200
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X L1869 Texas
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X L1869 Texas

Profile Details

NPI number 1083641062
LBN Legal business name Graham, Bradley Scott
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated May 22nd, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083641062 NPPES
Texas Other 8865K2 BLUE CROSS AND BLUE SHIELD PATHOLOGY
Texas MEDICAID 145796201 BLUE CROSS AND BLUE SHIELD PATHOLOGY
Texas Other 070016784 BLUE CROSS AND BLUE SHIELD PATHOLOGY
Texas Other 8A2682 BLUE CROSS AND BLUE SHIELD PATHOLOGY

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