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General NPI Number Information
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NPI Number | 1700406717
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Entity Type | Individual
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Provider Name | GRANT DIXON MD
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Gender | Male
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Dates
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Enumeration Date | 04/20/2020
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 1200 BROOKLYN AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78212-4803
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Country | US
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Telephone | 210-233-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 3922 GLENELLEN
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City | SAN ANTONIO
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State | TX
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Zip | 78257-1761
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Country | US
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Telephone | 512-638-3979
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Fax |
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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 | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | V9892
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | V9892
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License Number State | TX
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