Sophia Denise Graham, PRN PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2078618 Issued in TX

Practice address

110 E Medical Center Blvd
Webster, TX 77598-4301

Phone

(832) 224-9500

Fax

(832) 240-4757

NPI assigned

Aug 17, 2018

Sex

Female

Sole proprietor

No

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1639659741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8531 RIVERBEND CANYON LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770892572",
            "telephone_number": "832-244-7561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E MEDICAL CENTER BLVD",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984301",
            "telephone_number": "832-224-9500",
            "fax_number": "832-240-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "SOPHIA",
        "middle_name": "DENISE",
        "credential": "PRN PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2078618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Webster, TX
• Providers in Webster, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.