Provider Demographics
NPI:1578857694
Name:ALAN H. GRANT, O.D., CHTD.
Entity Type:Organization
Organization Name:ALAN H. GRANT, O.D., CHTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANT ALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:301-631-4366
Mailing Address - Street 1:7209 ARMAT DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-2107
Mailing Address - Country:US
Mailing Address - Phone:301-631-4366
Mailing Address - Fax:
Practice Address - Street 1:7209 ARMAT DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-2107
Practice Address - Country:US
Practice Address - Phone:301-631-4366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-06
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA0791152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty