Look up the most recent NPI and PECOS records

Robert Lynn Graham

Internal Medicine

Allopathic & Osteopathic Physicians

4001 W 15th St, Suite 245, Plano, TX 75093-5841

PECOS Enrollment

This provider is enrolled in PECOS as ROBERT GRAHAM.

Based on the most recent information from CMS, provider Robert Lynn Graham is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1871536367
Provider Type
Individual
Full Name
Graham, Robert Lynn
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
6/13/2006
Last Updated
10/24/2019

Contact Information

Practice Location

4001 W 15th St, Suite 245, Plano, TX 75093-5841

(972) 596-5222

(972) 596-5291

Mailing Location

4001 W 15th St, Suite 245, Plano, TX 75093-5841

(972) 596-5222

(972) 596-5291

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License E3559 Texas

Provider Identifiers

ID	Description	Issuer
ID 098163102	Description Medicaid	Issuer Unlisted Texas
ID 098163103	Description Other	Issuer MEDICAID OTHER Texas

Robert Lynn Graham

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

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