Travis Franklin Graham-Wyatt, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

30433 Issued in TX

Practice address

4730 College Dr
Vernon, TX 76384-4009

Phone

(940) 552-9901

NPI assigned

Sep 15, 2014

Last updated

Sep 15, 2014By the provider in NPPES

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

Other names 1

• Dr. Travis Franklin Graham Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 8, 2019 through Nov 8, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410739200000",
    "number": "1467853945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 COLLEGE DR",
            "city": "VERNON",
            "state": "TX",
            "postal_code": "763844009",
            "telephone_number": "940-552-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 COLLEGE DR",
            "city": "VERNON",
            "state": "TX",
            "postal_code": "763844009",
            "telephone_number": "940-552-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM-WYATT",
        "first_name": "TRAVIS",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-15",
        "last_updated": "2014-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "30433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRAVIS",
            "last_name": "GRAHAM",
            "middle_name": "FRANKLIN",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brysan Andrew Garrard, PHARMD
• General Anesthesia Services PA
• Shelley Lynn Gillis, P.T.
• Ann Louise Gilot
• Max Gilot, DPT
• Guardian Health Systems Vernon
• Tallea Haning
• Kay Hardage, RN
• Harrold Independent School District
• Hayley Eye Clinic PC (Hayley Eye Clinic of Vernon)

• Dentist in Vernon, TX
• Providers in Vernon, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.