Individual
BALA KOTESWARARAO GRANDHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
10864 TEXAS HEALTH TRL, FORT WORTH, TX 76244-4897
(682) 212-3160
(682) 212-9301
Mailing address
10864 TEXAS HEALTH TRL, FORT WORTH, TX 76244-4897
(682) 212-3160
(682) 212-9301
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301085576
MI
207R00000X
Internal Medicine Physician
Primary
Q2137
TX
Other
Enumeration date
05/08/2008
Last updated
10/13/2016
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