Provider Demographics
NPI:1467681791
Name:ANGUIANO, GRIZELDA MORALES (MD)
Entity Type:Individual
Prefix:MRS
First Name:GRIZELDA
Middle Name:MORALES
Last Name:ANGUIANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GRIZELDA
Other - Middle Name:
Other - Last Name:MORALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:GRIZELDA MORALES
Mailing Address - Street 1:18838 STONE OAK PKWY STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4179
Mailing Address - Country:US
Mailing Address - Phone:210-988-0210
Mailing Address - Fax:210-761-3829
Practice Address - Street 1:18838 STONE OAK PKWY STE 202
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4179
Practice Address - Country:US
Practice Address - Phone:210-988-0210
Practice Address - Fax:210-761-3829
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8499208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM8499OtherSTATE LIC
TX8CC343OtherBCBS
TX208758702OtherCSN
TXM8499OtherSTATE LIC
TXM8499OtherSTATE LIC