Healthcare Provider Details

I. General information

NPI: 1013903061
Provider Name (Legal Business Name): BARBARA ANNE GRAHAM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 03/14/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 N HIGHLAND AVE STE 260
SHERMAN TX
75092-7377
US

IV. Provider business mailing address

425 N HIGHLAND AVE STE 260
SHERMAN TX
75092-7377
US

V. Phone/Fax

Practice location:
  • Phone: 903-957-0082
  • Fax: 903-957-0351
Mailing address:
  • Phone: 903-957-0082
  • Fax: 903-957-0351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number036108269
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberQ2901
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: