Organization
RICHARD D. GRANT, JR., PH.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD D. GRANT JR. PH.D. (PYSCHOLOGIST)
(512) 338-0795
Entity
Organization
Contact information
Practice address
4131 SPICEWOOD SPRINGS RD, D-1, AUSTIN, TX 78759-8661
(512) 338-0795
Mailing address
4131 SPICEWOOD SPRINGS RD, D-1, AUSTIN, TX 78759-8661
(512) 338-0795
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
21476
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00PP11
BLUE CROSS/BLUE SHIELD
TX
Enumeration date
09/20/2006
Last updated
08/22/2020
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