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Individual

DR. CHRISTOPHER R. GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7700 FISH POND RD, WACO, TX 76710-1031
(254) 741-4444
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K1205
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080161868
RR/MEDICARE
TX
05
1031627-01
TX
01
84196K
BLUE SHIELD
TX
Enumeration date
03/25/2006
Last updated
12/10/2021
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