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General NPI Number Information
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NPI Number | 1720034804
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Entity Type | Individual
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Provider Name | CHESTER F GRAHAM M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 01/31/2017
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Provider Practice Location Address
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Address Line | 1105 CENTRAL EXPY N SUITE 360
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City | ALLEN
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State | TX
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Zip | 75013-6103
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Country | US
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Telephone | 214-691-1902
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Fax | 214-987-1845
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Provider Business Mailing Address
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Address Line | 3600 GASTON AVE SUITE 1205
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City | DALLAS
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State | TX
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Zip | 75246-1800
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Country | US
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Telephone | 214-692-8262
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Fax | 214-696-4190
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | H9214
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License Number State | TX
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