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Individual

PROF. JOHN ANDREW GRANT JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
301 UNIVERSITY BLVD, JOHN SEALY ANNEX 5.112, GALVESTON, TX 77555-0561
(409) 772-2436
(409) 772-9532
Mailing address
301 UNIVERSITY BLVD, JOHN SEALY ANNEX 5.112, GALVESTON, TX 77555-0561
(409) 772-2436
(409) 772-2035

Taxonomy

Speciality
Code
Description
License number
State
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
E1324
TX
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
49177
CO
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
E1324
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
117162102
TX
05
67226051
CO
Enumeration date
12/08/2006
Last updated
01/09/2014
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