MEDICARE: THE MEDICAL TEAM INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207PH0002X	Hospice and Palliative Medicine (Emergency Medicine) Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	741714	OTHER	TX	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	018123	OTHER	TX	LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639028210
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE MEDICAL TEAM INC

Provider Business Mailing Address
First Line	:	45 NE LOOP 410 STE 800
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-5837
Country	:	US
Telephone Number	:	210-227-9000
Fax Number	:	210-224-2020

Provider Business Practice Location Address
First Line	:	45 NE LOOP 410 STE 800
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-5837
Country	:	US
Telephone Number	:	210-227-9000
Fax Number	:	210-224-2020

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	RYAN GRISARD
Credential	:
Telephone Number	:	703-390-2321

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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Directions to “THE MEDICAL TEAM INC ” Practice Location

Language	Start Address	Practice Location

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