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Contact Information

MARY L GREAHAM, FNP
2617 BOLTON BOONE DR
SUITE A
DESOTO, TX75115-2074
 Phone: 972-572-9500
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for MARY L GREAHAM · (Female)

NPI Number 1821045931
Credentials FNP (Family Nurse Practitioner)
Entity Individual
Enumeration date 05/27/2006
Last updated 10/12/2007 - About 9 years ago
Sole proprietor 1 No
Identifiers
TX License # 735036
Medicare UPIN P7562
Hospital affiliation(s) n/a
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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