Provider Demographics
NPI:1437543162
Name:GRAHAM, CHRISTINA O (AUD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:O
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:ANN
Other - Last Name:OLIVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 99213
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0213
Mailing Address - Country:US
Mailing Address - Phone:682-885-3622
Mailing Address - Fax:682-885-3639
Practice Address - Street 1:6701 FANNIN ST # MC52030
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2608
Practice Address - Country:US
Practice Address - Phone:832-822-3249
Practice Address - Fax:832-825-8940
Is Sole Proprietor?:No
Enumeration Date:2015-03-19
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51511237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter