JACK M GRAHAM (NPI# 1205801347) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205801347 |
| Entity Type | Individual |
| Full Name | JACK M GRAHAM |
| Credential | M.D. |
| Practice Address |
1600 W College St Grapevine TX 76051-2100 |
| Mailing Address |
Po Box 100186 Fort Worth TX 76185-0186 |
| Practice Telephone | 8174810111 |
| Practice Fax Number | 8174810112 |
| Mailing Telephone | 8177317771 |
| Mailing Fax Number | 8177317774 |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2013-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | F1600 | TX | Allopathic & Osteopathic Physicians |
| Y | 207VM0101X |
Obstetrics & Gynecology Specialization: Maternal & Fetal Medicine |
F1600 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | 8H3360 | 01 |
| TX | AETNA | 4227216 | 01 |
| TX | 139366218 | 05 | |
| TX | AMERIGROUP | 10028874 | 01 |
| TX | 139366223 | 05 | |
| TX | 139366219 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306406863 | Jack Graham | Student in an Organized Health Care Education/Training Program | 8401 Market Street, Department of Medical Education, Boardman, OH 44512 | 2019-06-17 |
| 1447713920 | Jack Gregory Graham | Student in an Organized Health Care Education/Training Program | 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107-4206 | 2019-04-10 |
| Street Address |
1600 W COLLEGE ST |
| City | GRAPEVINE |
| State | TX |
| Zip Code | 76051-2100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275539439 | Timothy J Rost | Obstetrics & Gynecology | 1600 W College St, Ste 340, Grapevine, TX 76051-3577 | 2005-06-22 |
| 1215478326 | Cynthia Mace-motta, Do Pa | Obstetrics & Gynecology | 1600 W College St, Suite 260, Grapevine, TX 76051-3580 | 2017-03-09 |
| 1265984272 | Jeanette Lockett Wright | Nurse Practitioner | 1600 W College St, Suite 640, Grapevine, TX 76051-3580 | 2016-10-26 |
| 1194175851 | Kimberly S. Marshall, M.d., P.a. | Clinic/Center | 1600 W College St, Suite 340, Grapevine, TX 76051-3580 | 2016-06-14 |
| 1134577547 | Kimberly Salinas Marshall Md, Pa | Obstetrics & Gynecology | 1600 W College St, Suite 340, Grapevine, TX 76051-3580 | 2016-05-25 |
| 1073971404 | Carla L. Young, M.d., P.a. | Physical Medicine & Rehabilitation | 1600 W College St, Suite 685, Grapevine, TX 76051-3580 | 2016-01-30 |
| 1598136731 | Sofia A Lieser M D Pllc | Obstetrics & Gynecology | 1600 W College St, Suite 540, Grapevine, TX 76051-3580 | 2015-10-14 |
| 1538590286 | Melanie B. Kinchen, M.d., P.a. | Orthopaedic Surgery | 1600 W College St, Suite 685, Grapevine, TX 76051-3580 | 2013-12-05 |
| 1417383233 | Neurology Associates of Metroplex, P.a. | Psychiatry & Neurology | 1600 W College St, Suite Ll40, Grapevine, TX 76051-3580 | 2013-09-25 |
| 1487094389 | Baylor Health Enterprises Lp | Pharmacy | 1600 W College St, Suite 110, Grapevine, TX 76051-3580 | 2013-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881227346 | Jeffrey Joseph Cervenka | Physical Therapist | 2421 Ira E Woods Ave #101, Grapevine, TX 76051 | 2020-02-12 |
| 1871137562 | Karen Lorince | Counselor | 2409 N. Support Road, Grapevine, TX 76051 | 2019-11-05 |
| 1548733785 | Jessica Thorman Johnson | Dietitian, Registered | 1056 Texan Trail (fortis Bmi), Grapevine, TX 76051 | 2019-01-10 |
| 1164928958 | Kristen Diou | Counselor | 913 S Church St Ste 103, Grapevine, TX 76051 | 2018-04-02 |
| 1356860597 | Anissa Singratanakul D.m.d, Pllc | Dentist | 1231 William D Tate Suite 400, Grapevine, TX 76051 | 2017-09-19 |
| 1033637665 | James Abraham Thomas | Pharmacy | 1601 W. State Hwy 114, Grapevine, TX 76051 | 2017-09-04 |
| 1437606563 | D'anna Sims | Counselor | 2451 Stone Myers Parkway, #100, Grapevine, TX 76051 | 2016-09-07 |
| 1477006369 | Melinda Jeanne Mashburn | Nurse Practitioner | 1600 West College St., Suite 60, Grapevine, TX 76051 | 2016-07-27 |
| 1437506623 | Allcare Physicians Group | Registered Nurse | 1111 S Main St Ste 119, Grapevine, TX 76051 | 2016-05-18 |
| 1790141745 | Colwick Counseling | Clinic/Center | 1400 W. Northwest Highway Suite 260, Grapevine, TX 76051 | 2016-01-06 |
| Find all providers in zip 76051 | ||||
| Taxonomy Code | 207VM0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Maternal & Fetal Medicine |
| An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their effect on both the mother and the fetus. The specialist also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972679322 | Perinatal Medicine Associates, LLP | Obstetrics & Gynecology | 1600 W College St, Suite 210, Grapevine, TX 76051-3580 | 2006-11-28 |
| 1407821366 | Gerald Gene Payne Jr. | Obstetrics & Gynecology | 1600 W College St, Ste 210, Grapevine, TX 76051-3580 | 2006-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851990261 | Melissa Ann Cassady | Obstetrics & Gynecology | 6500 N Mo Pac Expy Ste 1205, Austin, TX 78731-3282 | 2020-10-19 |
| 1619433034 | Mariposa Perinatal Services Pllc | Obstetrics & Gynecology | 1510 W. Hwy 287 Bypass, Ste. 100, Waxahachie, TX 75165 | 2019-02-11 |
| 1558875898 | Texas Perinatology | Obstetrics & Gynecology | 413 Jackson Hill St, Houston, TX 77007-7409 | 2017-11-23 |
| 1699227298 | Perinatology and Genetics Pllc | Obstetrics & Gynecology | 6701 Heritage Pkwy Ste 145, Rockwall, TX 75087-8724 | 2016-10-30 |
| 1437501988 | Nima Goharkhay, Pllc | Obstetrics & Gynecology | 1016 Point Isabel Ln, Friendswood, TX 77546-7896 | 2016-07-08 |
| 1578939435 | Magdalena Sanz Cortes | Obstetrics & Gynecology | 6651 Main St., Texas Childrens Hospital Pavillion for Women.mfm Divisi, Houston, TX 77030 | 2015-08-14 |
| 1417357211 | Robert Patterson | Obstetrics & Gynecology | 3205 Pickwick Ln, Rollingwood, TX 78746-5516 | 2014-08-28 |
| 1134548399 | Mary Micaela Rieger | Obstetrics & Gynecology | 1313 Red River St Ste A1, Austin, TX 78701-1907 | 2014-04-15 |
| 1922447648 | John Byrne | Obstetrics & Gynecology | 315 N San Saba Ste 930, San Antonio, TX 78207-3154 | 2013-06-15 |
| 1083969299 | Caroline Marrs | Obstetrics & Gynecology | 7777 Forest Ln Ste 565, Dallas, TX 75230 | 2012-07-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.