Organization
GRAINGER DIAGNOSTIC CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY JACK GRAINGER DO (PRESIDENT)
(713) 694-9709
Entity
Organization
Contact information
Practice address
511A W TIDWELL RD, HOUSTON, TX 77091-4338
(713) 694-9709
Mailing address
511A W TIDWELL RD, HOUSTON, TX 77091-4338
(713) 694-9709
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E1595
TX
207RC0000X
Cardiovascular Disease Physician
E1595
TX
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
E1595
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165616701
—
TX
Enumeration date
05/28/2006
Last updated
04/12/2021
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