Provider Demographics
NPI:1316938434
Name:GRAHAM, WADE ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:WADE
Middle Name:ALAN
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1519 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6605
Mailing Address - Country:US
Mailing Address - Phone:956-968-3171
Mailing Address - Fax:956-968-5783
Practice Address - Street 1:1400 E RIDGE RD STE 3
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1536
Practice Address - Country:US
Practice Address - Phone:956-429-4900
Practice Address - Fax:956-429-4901
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK2910207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX046733404Medicaid
TXP00645448OtherRAILROAD MEDICARE
TX046733404Medicaid
TX8L0177Medicare PIN