Individual
STANLEY J GROSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3500 GASTON AVE, DALLAS, TX 75246
(214) 826-8822
(214) 826-9792
Mailing address
712 N WASHINGTON AVE, SUITE 101, DALLAS, TX 75246-1619
(214) 826-8822
(214) 826-9792
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
K0791
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129567706
—
TX
05
—
129567707
—
TX
05
—
129567709
—
TX
Enumeration date
05/19/2006
Last updated
02/16/2012
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