Provider Demographics
NPI:1154801793
Name:GRAHAM, JANAE RAMY (PTA)
Entity type:Individual
Prefix:MRS
First Name:JANAE
Middle Name:RAMY
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:JANAE
Other - Middle Name:RAMY
Other - Last Name:BLEVINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1675 NE LOOP 286
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-2219
Mailing Address - Country:US
Mailing Address - Phone:903-782-9922
Mailing Address - Fax:
Practice Address - Street 1:1675 NE LOOP 286
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-2219
Practice Address - Country:US
Practice Address - Phone:903-782-9922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2118000225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant