Provider Demographics
NPI:1316023922
Name:GROVER, TEJPAL S (MD)
Entity Type:Individual
Prefix:
First Name:TEJPAL
Middle Name:S
Last Name:GROVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 WESTWAY PARK BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-2006
Mailing Address - Country:US
Mailing Address - Phone:713-461-2915
Mailing Address - Fax:
Practice Address - Street 1:8810 ANTOINE DR STE 2015
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-1626
Practice Address - Country:US
Practice Address - Phone:713-461-2915
Practice Address - Fax:713-461-5307
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0311207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103676602Medicaid
83694KMedicare ID - Type Unspecified
TX103676602Medicaid