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NPI Code Detail

MEDICARE: DR. TINA P GRAU D.C.

MEDICARE: DR. TINA P GRAU D.C.
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
1111N00000XChiropractor4234TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11780784322OTHERTXBC/BS

General Provider Information

NPI Number : 1780784322
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TINA P GRAU D.C.
Provider Business Mailing Address
First Line : 510 MED COURT
Second Line : STE 207
City : SAN ANTONIO
State : TX
Zip : 78258-3484
Country : US
Telephone Number : 210-545-2001
Fax Number : 210-545-2168
Provider Business Practice Location Address
First Line : 510 MED COURT
Second Line : STE 207
City : SAN ANTONIO
State : TX
Zip : 78258-3484
Country : US
Telephone Number : 210-545-2001
Fax Number : 210-545-2168
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2006
Last Update Date : 07/18/2019

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Directions to “ DR. TINA P GRAU D.C.” Practice Location

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