Provider Demographics
NPI:1003313818
Name:GROSS, SARAH HALEY (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:HALEY
Last Name:GROSS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:MARY
Other - Last Name:HALEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:903 W MARTIN ST # MS 49-2
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-0903
Mailing Address - Country:US
Mailing Address - Phone:210-358-5909
Mailing Address - Fax:210-358-5940
Practice Address - Street 1:14615 SAN PEDRO AVE STE 218-220
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-4321
Practice Address - Country:US
Practice Address - Phone:210-644-3650
Practice Address - Fax:210-702-6979
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC202101212208000000X
TXV3310208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics