NPIMap

Individual provider Active NPI

Walter E Graham, MD

  • Anesthesiology Physician
  • Kingwood, TX
National Provider Identifier
1902880529
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
H4357 Issued in TX
Practice address
1331 North Park Drive
Kingwood, TX 77339
Phone
(281) 359-5330
Fax
(281) 359-6117
NPI assigned
Dec 6, 2005
Last updated
Sep 23, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD.15564R LA
Anesthesiology Physician 207L00000X H4357 TX Primary
Anesthesiology Physician 207L00000X 29172 CO
Emergency Medicine Physician 207P00000X H4357 TX
Family Medicine Physician 207Q00000X H4357 TX

Addresses

Primary practice location

1331 North Park Drive
Kingwood, TX 77339

Mailing address

1331 North Park Drive
Kingwood, TX 77339
Phone (281) 359-5330

Other identifiers 1

IdentifierTypeStateIssuer
1468037MedicaidLA

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29172COMDAnesthesiology Physician
MD.15564RLAMDAnesthesiology Physician
H4357TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Anesthesia Associates, LLP Past Accepting new patients
Dauterive Professionals Management Anesthesiology Past Accepting new patients
Stratus Anesthesia Associates Dallas PLLC Anesthesiology Past Accepting new patients
General Anesthesiology Services, P a Anesthesiology PastSince Sep 8, 2010 Accepting new patients
South Louisiana Anesthesiology Associates Inc Anesthesiology Past Accepting new patients
Graham Anesthesia Services LLC Anesthesiology PastSince Mar 6, 2006 Accepting new patients
Walter E Graham Mdpa PastSince May 1, 2000 Accepting new patients
Apex Anesthesia Associates LLC Past Accepting new patients

Organizations & group practices 9

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

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1902880529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 NORTH PARK DRIVE",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "77339",
            "telephone_number": "281-359-5330",
            "fax_number": "281-359-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 NORTH PARK DRIVE",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "77339",
            "telephone_number": "281-359-5330",
            "fax_number": "281-359-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "WALTER",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "LA",
            "license": "MD.15564R",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "H4357",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "29172",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "H4357",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H4357",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1468037",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.