Krista Grantham, PA-C
Physician Assistant, Surgical in San Antonio, TX. Individual provider (NPI-1).
NPI number1073920005
StatusActive
Last updated in NPPESDec 30, 2024
Details
- NPI
- 1073920005
- Entity type
- Individual (NPI-1)
- Name
- Krista Grantham
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 22, 2014
- Certification date
- Dec 30, 2024
- Last updated
- Dec 30, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | PA09328 | TX | Yes |
| 363A00000X | Physician Assistant | – | – |
Practice location
133 Terrell Rd Unit 9San Antonio, TX 78209-6329
Phone 830-221-6903
Mailing address
Po Box 6141San Antonio, TX 78209-0141
Phone 830-221-6903
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