Bradley Scott Graham, MD | |
1367 Dominion Plaza, Tyler, TX 75703-1013 | |
(903) 534-6200 | |
Not Available |
Full Name | Bradley Scott Graham |
---|---|
Gender | Male |
Speciality | Dermatology |
Experience | 34 Years |
Location | 1367 Dominion Plaza, Tyler, Texas |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083641062 | NPI | - | NPPES |
8865K2 | Other | TX | BLUE CROSS AND BLUE SHIELD PATHOLOGY |
145796201 | Medicaid | TX | |
070016784 | Other | TX | RAILROAD MEDICARE PTAN |
8A2682 | Other | TX | BLUE CROSS AND BLUE SHIELD CLINIC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207N00000X | Dermatology | L1869 (Texas) | Primary |
207ND0900X | Dermatology - Dermatopathology | L1869 (Texas) | Secondary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Oliver Street 5.01(a) Inc | 0042464125 | 144 |
Oliver Street 5.01(a) Inc | 0042464125 | 144 |
Entity Name | Oliver Street 5.01(a) Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457695413 PECOS PAC ID: 0042464125 Enrollment ID: O20130128000189 |
Mailing Address | Practice Location Address |
---|---|
Bradley Scott Graham, MD 1367 Dominion Plaza, Tyler, TX 75703-1013 Ph: () - | Bradley Scott Graham, MD 1367 Dominion Plaza, Tyler, TX 75703-1013 Ph: (903) 534-6200 |
Shanna Burris Meads, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1367 Dominion Plz, Tyler, TX 75703 Phone: 903-534-6200 | |
Stephen John Beck, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 1367 Dominion Plz, Tyler, TX 75703 Phone: 903-534-6200 Fax: 903-939-0755 | |
Alma Criseida Berlingeri Ramos, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1367 Dominion Plz, Tyler, TX 75703 Phone: 903-534-6200 Fax: 903-939-0755 | |
Elizabeth Stripling Morris, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1367 Dominion Plaza, Tyler, TX 75703 Phone: 903-534-6200 | |
Lawrence Lazelle Anderson, MD Dermatology Medicare: Medicare Enrolled Practice Location: 1367 Dominion Plaza, Tyler, TX 75703 Phone: 903-534-6200 | |
Thomas Lambert Jr., MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 5791 Copeland Rd, Tyler, TX 75703 Phone: 903-509-2020 |