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Organization

BEANSPROUT PEDIATRICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DANIELLE DENISE GRANT M.D. (OWNER/PHYSICIAN)
(512) 610-7030
Entity
Organization

Contact information

Practice address
13917 W HIGHWAY 71 STE A, AUSTIN, TX 78738-3008
(512) 610-7030
(512) 610-7034
Mailing address
13917 W HIGHWAY 71 STE A, AUSTIN, TX 78738-3008
(512) 610-7030
(512) 610-7034

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2080A0000X
Pediatric Adolescent Medicine Physician
Primary

Other

Enumeration date
05/11/2010
Last updated
02/12/2019
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