Individual
JENNIFER L GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1325 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2158
(817) 761-7740
Mailing address
DEPARTMENT OF SURGERY UT SOUTHWESTERN MEDICAL CENTER, 5323 HARRY HINES BLVD, DALLAS, TX 75390-9159
(214) 648-3917
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Q9621
TX
2086S0102X
Surgical Critical Care Physician
Primary
Q9621
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2011
Last updated
10/24/2023
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