Healthcare Provider Details

I. General information

NPI: 1629557681
Provider Name (Legal Business Name): ANNDEE GRITTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2018
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 W AGARITA AVE
SAN ANTONIO TX
78212-2804
US

IV. Provider business mailing address

522 N MEADOWLANE DR
SAN ANTONIO TX
78209-4716
US

V. Phone/Fax

Practice location:
  • Phone: 612-629-7733
  • Fax:
Mailing address:
  • Phone: 361-549-1650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number62880
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: