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General NPI Number Information
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NPI Number | 1386629012
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Entity Type | Individual
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Provider Name | MICHAEL SCOTT GRAD M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/15/2005
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 2200 PARK BEND DR BLDG 1 SUITE 401
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City | AUSTIN
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State | TX
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Zip | 78758-5387
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Country | US
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Telephone | 512-615-9901
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Fax | 512-807-3335
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Provider Business Mailing Address
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Address Line | 2200 PARK BEND DR BLDG 1 SUITE 401
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City | AUSTIN
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State | TX
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Zip | 78758-5387
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Country | US
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Telephone | 512-901-4001
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Fax | 512-339-7743
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | L4956
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | L4956
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License Number State | TX
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