Graham, Kevin

Graham, Kevin is an individual health care provider with primary practice located at 221 3Rd St W , Jbsa Randolph TX 78150-4800. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Graham, Kevin can be contacted via phone (210) 221-6144.

Contact Information

Primary practice address
221 3Rd St W Jbsa Randolph TX 78150-4800
Phone: (210) 221-6144
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1346671765
LBN Legal business name Graham, Kevin
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 11th, 2013
Last updated Sep 25th, 2019 - about 5 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 1346671765 NPPES
Other NA TRICARE/DOD

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