Robert Blake Graham, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

12979 Issued in TX

Practice address

2500 Lakeside Pkwy
Ste 120
Flower Mound, TX 75022-4116

Phone

(214) 285-8774

NPI assigned

Jul 28, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Adnogon Sports Medicine

  • Sports Physician Chiropractor
  • Flower Mound, TX
  • NPI 1275117590
  NPD

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1427433754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 NORTHWOOD DR",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750224506",
            "telephone_number": "972-533-2950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 LAKESIDE PKWY",
            "address_2": "STE 120",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750224116",
            "telephone_number": "214-285-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ROBERT",
        "middle_name": "BLAKE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-28",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "TX",
            "license": "12979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Gordon
• Kori Gorman
• Karma Marie Gottlieb
• Katina Delette Grabert, LCDC
• Grace Elizabeth Brown, MD PA
• Rossalya Aracely Granda Gutierrez
• Lilliesha Grandberry
• Jane C. Gray, LPC
• Mary Catherine Gray, PT
• Melanie Gray, D.O.

• Sports Physician Chiropractor in Flower Mound, TX
• Providers in Flower Mound, TX by specialty
• Sports Physician Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.