Organization
GRANTHAM MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTA GRANTHAM PA-C (OWNER)
(830) 221-6903
Entity
Organization
Contact information
Practice address
133 TERRELL RD UNIT 9, SAN ANTONIO, TX 78209-6329
(830) 221-6903
Mailing address
PO BOX 6141, SAN ANTONIO, TX 78209-0141
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
12/16/2024
Last updated
12/30/2024
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