Individual
GRANT EDWIN KIRBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1500 COOPER ST, FORT WORTH, TX 76104-2710
(682) 885-7080
(682) 885-7085
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-1855
(682) 885-1396
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA01989
TX
363AS0400X
Surgical Physician Assistant
Primary
PA01989
TX
Other
Enumeration date
08/11/2006
Last updated
05/05/2021
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