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General NPI Number Information
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NPI Number | 1700945342
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Entity Type | Individual
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Provider Name | JOHN ANDREW GRANT JR. MD
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Gender | Male
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 01/09/2014
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Provider Practice Location Address
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Address Line | 301 UNIVERSITY BLVD JOHN SEALY ANNEX 5.112
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City | GALVESTON
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State | TX
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Zip | 77555-0561
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Country | US
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Telephone | 409-772-2436
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Fax | 409-772-9532
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Provider Business Mailing Address
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Address Line | 301 UNIVERSITY BLVD JOHN SEALY ANNEX 5.112
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City | GALVESTON
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State | TX
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Zip | 77555-0561
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Country | US
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Telephone | 409-772-2436
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Fax | 409-772-2035
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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 | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number | 49177
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number | E1324
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207KI0005X
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Taxonomy Name | Clinical & Laboratory Immunology (Allergy & Immunology) Physician
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License Number | E1324
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License Number State | TX
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