Provider Demographics
NPI:1255384145
Name:GRANT, CATHAL P (MD)
Entity type:Individual
Prefix:
First Name:CATHAL
Middle Name:P
Last Name:GRANT
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:1604 HOSPITAL PKWY
Mailing Address - Street 2:SUITE. 507
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6986
Mailing Address - Country:US
Mailing Address - Phone:817-354-7268
Mailing Address - Fax:817-354-9930
Practice Address - Street 1:1604 HOSPITAL PKWY
Practice Address - Street 2:SUITE 507
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6986
Practice Address - Country:US
Practice Address - Phone:817-354-7268
Practice Address - Fax:817-354-9930
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2008-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH71522084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE38627Medicare UPIN
TX00F55ZMedicare PIN