Provider Demographics
NPI:1023560232
Name:GRAMMER, HERBERT JAMES
Entity Type:Individual
Prefix:MR
First Name:HERBERT
Middle Name:JAMES
Last Name:GRAMMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13309 VIZQUEL LOOP
Mailing Address - Street 2:
Mailing Address - City:DEL VALLE
Mailing Address - State:TX
Mailing Address - Zip Code:78617-5749
Mailing Address - Country:US
Mailing Address - Phone:512-585-7212
Mailing Address - Fax:
Practice Address - Street 1:13309 VIZQUEL LOOP
Practice Address - Street 2:
Practice Address - City:DEL VALLE
Practice Address - State:TX
Practice Address - Zip Code:78617-5749
Practice Address - Country:US
Practice Address - Phone:512-585-7212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker