Provider Demographics
NPI:1902859234
Name:GRABHORN, LARRY LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:LEE
Last Name:GRABHORN
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 1:15338 BOUNTY AVE
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-6347
Mailing Address - Country:US
Mailing Address - Phone:361-949-4615
Mailing Address - Fax:
Practice Address - Street 1:BAMC
Practice Address - Street 2:3851 ROGER BROOKE DRIVE MCHE-QD (CREDS)
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-6200
Practice Address - Country:US
Practice Address - Phone:361-961-3151
Practice Address - Fax:361-961-4823
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ34852083A0100X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
Not Answered2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine