Provider Demographics
NPI:1710128442
Name:HOWARD GRANT, P.A.
Entity Type:Organization
Organization Name:HOWARD GRANT, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-545-0024
Mailing Address - Street 1:2646 S LOOP W
Mailing Address - Street 2:SUITE #400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2665
Mailing Address - Country:US
Mailing Address - Phone:832-545-0024
Mailing Address - Fax:713-661-4529
Practice Address - Street 1:2646 S LOOP W
Practice Address - Street 2:SUITE #400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2665
Practice Address - Country:US
Practice Address - Phone:832-545-0024
Practice Address - Fax:713-661-4529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF2265207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00G596Medicare UPIN