Individual
MANIZEH MIRZA-GRUBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 HAVEN FOR HOPE WAY, SAN ANTONIO, TX 78207-1266
(210) 261-1437
Mailing address
6800 PARK TEN BLVD STE 200S, SAN ANTONIO, TX 78213-4293
(210) 261-1060
(210) 261-1821
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
J4357
TX
2084P0804X
Child & Adolescent Psychiatry Physician
J4357
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188429801
—
TX
Enumeration date
08/30/2006
Last updated
09/25/2024
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