Individual
DR. SEAN C. GRINOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 UNIVERSITY BLVD, ROUND ROCK, TX 78665-1032
(512) 509-2020
Mailing address
PO BOX 847408, DALLAS, TX 75284-7408
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
K0310
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1029589-01
CSHCN
TX
05
—
1029589-02
—
TX
01
—
180040587
RR/MEDICARE
TX
01
—
82706N
BLUE SHIELD
TX
Enumeration date
03/23/2006
Last updated
07/13/2007
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