Healthcare Provider Details

I. General information

NPI: 1467545004
Provider Name (Legal Business Name): MORRIS D. GROVES JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 02/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 W 38TH ST STE 200
AUSTIN TX
78705-1165
US

IV. Provider business mailing address

PO BOX 911230
DALLAS TX
75391-1230
US

V. Phone/Fax

Practice location:
  • Phone: 512-421-4100
  • Fax: 512-454-4575
Mailing address:
  • Phone: 972-997-8000
  • Fax: 972-234-2987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberH2938
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberH2938
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: