Healthcare Provider Details
I. General information
NPI: 1487645446
Provider Name (Legal Business Name): DAVID C GRAUMLICH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/31/2005
Last Update Date: 05/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
605 HOLDERRIETH BLVD
TOMBALL TX
77375-6445
US
IV. Provider business mailing address
800 ROCKMEAD DR S:210
KINGWOOD TX
77339-2112
US
V. Phone/Fax
- Phone: 281-359-7788
- Fax: 281-359-7888
- Phone: 281-359-7788
- Fax: 281-359-7888
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | E3008 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: