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NPI Code Detail

MEDICARE: GRACE EMERGENCY PHYSICIANS

MEDICARE: GRACE EMERGENCY PHYSICIANS
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
1207P00000XEmergency Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10045JKOTHERTXBCBS

General Provider Information

NPI Number : 1679528202
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRACE EMERGENCY PHYSICIANS
Provider Business Mailing Address
First Line : PO BOX 41493
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19101-1493
Country : US
Telephone Number : 800-355-0808
Fax Number :
Provider Business Practice Location Address
First Line : 506 E SAN ANTONIO ST
Second Line :
City : VICTORIA
State : TX
Zip : 77901-6060
Country : US
Telephone Number : 361-788-6680
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. JAMES BRAND
Credential : MD
Telephone Number : 214-712-2074
Provider Enumeration Date : 05/23/2006
Last Update Date : 08/22/2020

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Directions to “GRACE EMERGENCY PHYSICIANS ” Practice Location

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