Provider Demographics
NPI:1902934433
Name:CHRISTY LYNN GRAHAM, D.C.,P.C.
Entity Type:Organization
Organization Name:CHRISTY LYNN GRAHAM, D.C.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CONSTANTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-367-5020
Mailing Address - Street 1:25144 GROGANS PARK DR
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2167
Mailing Address - Country:US
Mailing Address - Phone:281-367-5020
Mailing Address - Fax:281-466-1019
Practice Address - Street 1:25144 GROGANS PARK DR
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-2167
Practice Address - Country:US
Practice Address - Phone:281-367-5020
Practice Address - Fax:281-466-1019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0050AZOtherBCBS OF TEXAS
TX0050AZMedicare ID - Type Unspecified