| Paul A Grant Jr, MD | |
|
1612 S Henderson Blvd, Kilgore, TX 75662-3518 | |
| (903) 984-3505 | |
| Not Available |
| Full Name | Paul A Grant Jr |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 1612 S Henderson Blvd, Kilgore, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336196989 | NPI | - | NPPES |
| 0027MP | Other | TX | BLUE CROSS BLUE SHIELD |
| 156199502 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | J8559 (Texas) | Primary |
| Entity Name | Concord Medical Group Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083630610 PECOS PAC ID: 0446296818 Enrollment ID: O20050707000531 |
| Entity Name | Texas Medicine Resources, Llp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376581900 PECOS PAC ID: 5890688212 Enrollment ID: O20130702000785 |
| Entity Name | Concord Medical Group Of Texas Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750790762 PECOS PAC ID: 7810117223 Enrollment ID: O20141007002567 |
| Entity Name | Concord North Texas Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952761173 PECOS PAC ID: 2860791688 Enrollment ID: O20160429000472 |
| Entity Name | Primary Health Physicians Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770048704 PECOS PAC ID: 7810237740 Enrollment ID: O20190312003418 |
| Mailing Address | Practice Location Address |
|---|---|
| Paul A Grant Jr, MD Po Box 8549, Fort Worth, TX 76124-0549 Ph: (817) 451-4208 | Paul A Grant Jr, MD 1612 S Henderson Blvd, Kilgore, TX 75662-3518 Ph: (903) 984-3505 |
Alan S Clark, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1612 S Henderson Blvd, Kilgore, TX 75662 Phone: 903-984-3505 | |
Eulogio Bonsukan, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1612 S Henderson Blvd, Kilgore, TX 75662 Phone: 903-984-3505 | |
Dr. Michael Mcshan, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1711 S Henderson Blvd, Suite 100, Kilgore, TX 75662 Phone: 903-315-3800 Fax: 903-984-5367 |