Robert R Graham, CRNA

Individual provider Active NPI Certified Registered Nurse Anesthetist · Weimar, TX

NPI 1811099153 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1811099153
Entity type
Individual (NPI type 1)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
License
027848 (TX)
Practice address
400 Youens Dr
Weimar, TX 78962
Phone
(979) 725-9531
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
027848TXMDCertified Registered Nurse Anesthetist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 027848 TX Yes

Addresses

Primary practice location

400 Youens Dr
Weimar, TX 78962

Mailing address

1570 CR 250
Weimar, TX 78962
Phone (979) 263-5200

Other providers in Weimar, TX

All providers in Weimar, TX · Certified Registered Nurse Anesthetist in Texas

Sources for this page

Verify at the official NPI Registry.