Provider Demographics
NPI:1619959939
Name:GRANT, JAMES CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CHRISTOPHER
Last Name:GRANT
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 1:10740 N GESSNER DR
Mailing Address - Street 2:STE 310
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-1240
Mailing Address - Country:US
Mailing Address - Phone:281-897-0416
Mailing Address - Fax:281-809-8908
Practice Address - Street 1:561 MEDICAL CENTER BLVD
Practice Address - Street 2:STE A
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4240
Practice Address - Country:US
Practice Address - Phone:281-338-1423
Practice Address - Fax:281-316-2173
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1206207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1171126-01Medicaid
TX222771OtherBEECHSTREET
TX117112602Medicaid
TX81466NMedicare PIN
TX222771OtherBEECHSTREET
TX8289J3Medicare PIN
TX1171126-01Medicaid