Healthcare Provider Details

I. General information

NPI: 1073917241
Provider Name (Legal Business Name): RANJIT GREWAL MDPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 10/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21216 NORTHWEST FWY STE 260
CYPRESS TX
77429-4695
US

IV. Provider business mailing address

21216 NORTHWEST FWY STE 260
CYPRESS TX
77429-4695
US

V. Phone/Fax

Practice location:
  • Phone: 281-477-0525
  • Fax: 281-477-0526
Mailing address:
  • Phone: 281-477-0525
  • Fax: 281-477-0526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RANJIT GREWAL
Title or Position: OWNER
Credential: MD
Phone: 281-477-0525