Individual
KRISTA GRANTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
133 TERRELL RD UNIT 9, SAN ANTONIO, TX 78209-6329
(830) 221-6903
Mailing address
PO BOX 6141, SAN ANTONIO, TX 78209-0141
(830) 221-6903
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
PA09328
TX
Other
Enumeration date
07/22/2014
Last updated
12/30/2024
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