Individual
GRANT CHARLES RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1318 MESA DRAW, SAN ANTONIO, TX 78258-2623
(850) 252-3344
Mailing address
1318 MESA DRAW, SAN ANTONIO, TX 78258-2623
(850) 252-3344
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/03/2025
Last updated
07/03/2025
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