Kevin Graham

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

221 3Rd St W
Jbsa Randolph, TX 78150-4800

Phone

(210) 221-6144

NPI assigned

Dec 11, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Universal Physicians PA

  • Contractor
  • Houston, TX
  • NPI 1548477805
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1386720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1346671765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 3RD ST W",
            "city": "JBSA RANDOLPH",
            "state": "TX",
            "postal_code": "781504800",
            "telephone_number": "210-221-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 3RD ST W",
            "city": "JBSA RANDOLPH",
            "state": "TX",
            "postal_code": "781504800",
            "telephone_number": "210-221-6144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6565 West Loop S Ste 525",
            "address_purpose": "LOCATION",
            "city": "Bellaire",
            "state": "TX",
            "postal_code": "774013519",
            "country_code": "US",
            "telephone_number": "713-661-7888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-11",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/DOD",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "other",
            "affiliation": "N",
            "address_1": "221 3rd St W",
            "city": "Jbsa Randolph",
            "state": "TX",
            "country_code": "US",
            "postal_code": "781504800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica-Renee Gamboa, M.D.
• Kimberly George, MS, RD, LD, CDCES
• Cassandra Jane Gilbert, MSW
• Michelle Gonzales, PHD, WHNP-BC
• Megan Jenifer Graff, D.M.D.
• Ian David Gregory, D.O.
• Christopher Mark Grussendorf, MD, MPH
• Jacqueline Gutierrez, MD
• Gloria J Heater, PA-C
• Jessica Audrey Hess, DDS

• Physician Assistant in Jbsa Randolph, TX
• Providers in Jbsa Randolph, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.