| Doctor Name: | MR. CAL WADE GRAVES |
| NPI Number: | 1013154772 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | PA06373 |
| Business Practice Address: | 1948 E Hebron Pkwy Ste 110 Carrollton, TX - 750071525 |
| Business Phone Number: | 9729394646 |
| Business Fax Number: | |
| Mailing Address: | 2336 Whistler Creek Dr, Apt 127 FORT WORTH |
| State: | TX |
| Postal Code: | 761778221 |
| Phone Number: | 8173430773 |
| Fax Number: | |
| NPI Enumeration Date: | 01/15/2009 |
| NPI Last Update Date: | 12/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA06373 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |