MEDICARE: ONE HEALTH

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1699612119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONE HEALTH

Provider Business Mailing Address
First Line	:	122 HASLER SHORES DR STE 101
Second Line	:
City	:	BASTROP
State	:	TX
Zip	:	78602-4247
Country	:	US
Telephone Number	:	512-293-0936
Fax Number	:	800-547-1293

Provider Business Practice Location Address
First Line	:	122 HASLER SHORES DR STE 101
Second Line	:
City	:	BASTROP
State	:	TX
Zip	:	78602-4247
Country	:	US
Telephone Number	:	512-293-0936
Fax Number	:	800-547-1293

Authorized Official
Title or Position	:	ACCOUNT MANAGER
Name	:	NICOLE GROSSI
Credential	:
Telephone Number	:	814-346-1227

Provider Enumeration Date	:	05/01/2026
Last Update Date	:	05/01/2026

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Directions to “ONE HEALTH ” Practice Location

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