Healthcare Provider Details

I. General information

NPI: 1487595484
Provider Name (Legal Business Name): OSCAR DE'PREE GRAVES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23302 TREE BRIGHT LN
SPRING TX
77373-7058
US

IV. Provider business mailing address

23302 TREE BRIGHT LN 23302 TREE BRIGHT LN
SPRING TX
77373-7058
US

V. Phone/Fax

Practice location:
  • Phone: 737-717-7327
  • Fax:
Mailing address:
  • Phone: 737-717-7327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number07554056
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: