MEDICARE: DR. THOMAS M. GRANT PHD, LCSW,LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	10384	TX
2	103T00000X	Psychologist	20423	TX

General Provider Information

NPI Number	:	1891787842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS M. GRANT PHD, LCSW,LPC

Provider Business Mailing Address
First Line	:	8245 FREDERICKSBURG RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3356
Country	:	US
Telephone Number	:	210-616-0022
Fax Number	:	210-616-0258

Provider Business Practice Location Address
First Line	:	8245 FREDERICKSBURG RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3356
Country	:	US
Telephone Number	:	210-616-0022
Fax Number	:	210-616-0258

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	09/11/2025

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