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General NPI Number Information
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NPI Number | 1366908865
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Entity Type | Individual
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Provider Name | HOLDEN T GRAVES PHARMD
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Gender | Male
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Dates
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Enumeration Date | 02/20/2019
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Last Update Date | 09/16/2019
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Provider Practice Location Address
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Address Line | 1340 EMPIRE CENTRAL DR
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City | DALLAS
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State | TX
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Zip | 75247-4022
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Country | US
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Telephone | 214-867-6809
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Fax |
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Provider Business Mailing Address
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Address Line | 6608 MANZANO ST
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City | MCKINNEY
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State | TX
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Zip | 75070-7372
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Country | US
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Telephone | 479-524-7672
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PD14038
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 60914
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License Number State | TX
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