Individual
DR. BRADLEY JAY GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, JD
Contact information
Practice address
301 UNIVERSITY BLVD DEPT OF, GALVESTON, TX 77555-5302
(409) 772-2870
(409) 747-2400
Mailing address
PO BOX 650859, DALLAS, TX 75265-0859
(409) 772-2222
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
U1021
TX
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
Primary
U1021
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
72566
UNITED STATES PATENT AND TRADEMARK OFFICE REGISTRATION NUMBER
—
01
—
BP10074431
TEXAS PHYSICIAN IN TRAINING PERMIT
TX
Enumeration date
06/08/2021
Last updated
12/04/2024
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