Healthcare Provider Details

I. General information

NPI: 1245561257
Provider Name (Legal Business Name): RANJIT S. GREWAL M.D., PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2010
Last Update Date: 09/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11307 FM 1960 RD W SUITE 350
HOUSTON TX
77065-3687
US

IV. Provider business mailing address

11307 FM 1960 RD W SUITE 350
HOUSTON TX
77065-3687
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 NumberN4441
License Number StateTX

VIII. Authorized Official

Name: RANJIT S. GREWAL
Title or Position: MEDICAL DOCTOR
Credential: MD
Phone: 281-477-0525