DR. KENNETH JEROME GRAVES (NPI# 1275689416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275689416 |
| Entity Type | Individual |
| Full Name | DR. KENNETH JEROME GRAVES |
| Credential | PH.D. |
| Practice Address |
1005 W Jefferson Blvd Suite 205 Dallas TX 75208-5087 |
| Mailing Address |
3551 Roger Brooke Dr San Antonio TX 78234-4504 |
| Practice Telephone | 2149164025 |
| Mailing Telephone | 2109166299 |
| Enumeration Date | 2007-01-27 |
| Last Update Date | 2018-04-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
30557 | TX | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
30557 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 0962334-01 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588680334 | Kenneth Murdock Graves | Dentist | A-112-dent American Lake Vamc Dental Clinic, Tacoma, WA 98493-0001 | 2006-07-14 |
| 1972092401 | Kenneth L. Graves | Counselor | 400 Bowman St, Mansfield, OH 44903-1235 | 2018-05-10 |
| 1114304920 | Kenneth Graves Jr. | Counselor | 1000 Quail St, #189, Newport Beach, CA 92660-2731 | 2015-04-30 |
| 1689642506 | Kenneth Wayne Graves | Military Health Care Provider | Naval Hospital Corpus Christi, 10651 E Street, Corpus Christi, TX 78419-5130 | 2006-03-08 |
| Street Address |
1005 W JEFFERSON BLVD SUITE 205 |
| City | DALLAS |
| State | TX |
| Zip Code | 75208-5087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447364260 | James Douglas Calvert | Psychologist | 1005 W Jefferson Blvd, Suite 205, Dallas, TX 75208-5087 | 2006-08-18 |
| 1861848822 | Kathleen C. Hardin | Speech-Language Pathologist | 1005 W Jefferson Blvd, Ste 300, Dallas, TX 75208-5087 | 2016-05-09 |
| 1427460617 | Kay Simon | Speech-Language Pathologist | 1005 W Jefferson Blvd, Suite 306, Dallas, TX 75208-5087 | 2014-05-22 |
| 1841540424 | Jose G Torres | Counselor | 1005 W Jefferson Blvd, Suit 205, Dallas, TX 75208-5087 | 2012-09-11 |
| 1760739858 | Dallas Reading and Language Services, PC | Speech-Language Pathologist | 1005 W Jefferson Blvd, Suite 306, Dallas, TX 75208-5087 | 2012-08-08 |
| 1780818096 | Marisol Vargas | Dentist | 1005 W Jefferson Blvd, Suite 401, Dallas, TX 75208-5087 | 2009-05-14 |
| 1326219320 | Leilani Kyoko Oana | Psychologist | 1005 W Jefferson Blvd, Suite 205, Dallas, TX 75208-5087 | 2008-03-18 |
| 1578630364 | Emily Aline Fallis | Psychologist | 1005 W Jefferson Blvd, Dallas, TX 75208-5087 | 2006-11-29 |
| 1093881138 | James Robert Womack | Psychologist | 1005 W Jefferson Blvd, Suite 205, Dallas, TX 75208-5087 | 2006-11-28 |
| 1548339641 | Dianne Robinson | Counselor | 1005 W Jefferson Blvd, Suite 203, Dallas, TX 75208-5087 | 2006-11-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962048710 | Roshonda Guest | Counselor | 529 W. Commerce, 1414, Dallas, TX 75208 | 2019-11-26 |
| 1316506025 | Molecular Innovations Neo-designs Laboratories, LLC | Clinical Medical Laboratory | 839 W. Commerce, Dallas, TX 75208 | 2019-06-07 |
| 1477023430 | Amber M James Dmd, Pllc | Dentist | 650 Fort Worth Ave, Ste 130, Dallas, TX 75208 | 2018-12-03 |
| 1659841237 | Andrea Pavia-jimenez | Physician Assistant | 817 Jefferson Blvd, Dallas, TX 75208 | 2018-11-27 |
| 1841716859 | Jennifer Atherton | Midwife | 618 S Rosemont Ave, Dallas, TX 75208 | 2017-08-22 |
| 1659815892 | Texas Traumatic Brain Injury Rehab | Counselor | 214 W. Colorado Blvd., Dallas, TX 75208 | 2016-12-07 |
| 1295120111 | Silva Pharmacy, Inc | Pharmacy | 939 W Jefferson Blvd Ste 101, Dallas, TX 75208 | 2015-03-30 |
| 1487052478 | Kassandra Sanchez | Counselor | 210 West 10th Street, Dallas, TX 75208 | 2014-12-08 |
| 1023458650 | O.c Medical Associates Pa | Internal Medicine | 737 N. Bishop Avenue, Ste B, Dallas, TX 75208 | 2013-06-27 |
| 1306105135 | Sts Dental, Pllc | Dentist | 909 S. Tyler St., Dallas, TX 75208 | 2012-05-14 |
| Find all providers in zip 75208 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013517267 | Hunter Boone Small | Psychologist | 5940 Forest Park Rd Apt 1100, Dallas, TX 75235-6444 | 2020-10-27 |
| 1144834268 | Jeffrey Baldridge | Psychologist | 8140 Walnut Hill Ln Ste 450, Dallas, TX 75231-4328 | 2020-09-04 |
| 1871104760 | Nicole Elizabeth Hooper | Psychologist | 1 Stonebriar Ct, Dallas, TX 75206-8812 | 2020-08-13 |
| 1992313522 | Aisha Iqbal | Psychologist | 5454 La Sierra Dr Ste 201, Dallas, TX 75231-2344 | 2020-07-20 |
| 1801430483 | Yaffa Podbilewicz-schuller | Psychologist | 6618 Elvedon Dr, Dallas, TX 75248-1324 | 2019-11-06 |
| 1578111993 | Anne Caroline Brasch | Psychologist | 6750 Hillcrest Plaza Dr Ste 206, Dallas, TX 75230-1438 | 2019-08-28 |
| 1215497672 | Tiffany Armstrong | Psychologist | 8350 N Central Expy Ste 1275, Dallas, TX 75206-1614 | 2019-03-21 |
| 1275001208 | Bryan Elliott Jester | Psychologist | 4100 Spring Valley Rd Ste 511, Dallas, TX 75244-3678 | 2018-11-07 |
| 1003398074 | Aaron Hands | Psychologist | 5646 Milton St Ste 740, Dallas, TX 75206 | 2018-09-05 |
| 1174001960 | Robert Butler Hampson | Psychologist | 5910 N. Central Expressway, Suite 1820, Dallas, TX 75206 | 2018-08-02 |
| Find all providers in DALLAS | ||||
Please comment or provide details below to improve the information on DR. KENNETH JEROME GRAVES.
| 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.