| NPI Details | |
|---|---|
| NPI | 1003810888 |
| Gender | Male |
| Enumeration Date | 06/09/2005 |
| Last Updated | 07/09/2007 |
| Entity Type | Individual |
| Active | Over 13 years ago |
| Practice Location | |
|---|---|
| 5282 MEDICAL DR STE 310 SAN ANTONIO TX, 78229-6044, US |
|
| Phone | (210) 614-8687 |
| Fax | (210) 614-7529 |
| Business Location | |
|---|---|
| 5282 MEDICAL DR STE 310 SAN ANTONIO TX, 78229-6044, US |
|
| Phone | (210) 614-8687 |
| Fax | (210) 614-7529 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 208000000X |
| License State | Texas |
| License Number | D3243 |
| Remove 1003810888 NPI Number | |
According to our database, Dr. Wilson Wayne Grant M.D. NPI is 1003810888, taxonomy code is 208000000X and license number is D3243, license state is located at Texas. Wilson Wayne Grant M.D. physically located at 5282 Medical Dr, San Antonio TX, 78229-6044. NPI Number Wilson Wayne Grant M.D. has the Individual type.
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1003810888 NPI number is provided on an as is basis without warranty of any kind. 1003810888 is maintained by the National Plan & Provider Enumeration System. The contents of Wilson Wayne Grant M.D. are for informational purposes only.
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