Individual
GRANT T. ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 HILLCREST MEDICAL BLVD, WACO, TX 76712-8897
(254) 202-2000
(254) 202-5651
Mailing address
PO BOX 848491, DALLAS, TX 75284-8491
(254) 724-8800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
31214
AL
207R00000X
Internal Medicine Physician
R1339
TX
208M00000X
Hospitalist Physician
Primary
R1339
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31214
AL LICENSE NUMBER
AL
Enumeration date
08/04/2009
Last updated
09/04/2020
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