Provider Demographics
NPI:1689026437
Name:GRASSO, SAMUEL L (DO)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:L
Last Name:GRASSO
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Gender:M
Credentials:DO
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Mailing Address - Street 1:5005 N. PIEDRAS STREET ATTN; GME
Mailing Address - Street 2:WILLIAM BEAUMONT ARMY MEDICAL CENTER
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79920-5001
Mailing Address - Country:US
Mailing Address - Phone:915-742-2597
Mailing Address - Fax:915-742-6668
Practice Address - Street 1:5005 N. PIEDRAS ST ATTN; GME
Practice Address - Street 2:WILLIAM BEAUMONT ARMY MEDICAL CENTER
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79920-5001
Practice Address - Country:US
Practice Address - Phone:915-742-2597
Practice Address - Fax:915-742-6668
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2023-04-19
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Provider Licenses
StateLicense IDTaxonomies
TXT8214208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery