| Grey Canyon Family Medicine Pa | |
|
20658 Stone Oak Pkwy Ste 108 San Antonio TX 78258 | |
| (210) 615-9990 | |
| (210) 615-9909 |
| Full Name | Grey Canyon Family Medicine Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 20658 Stone Oak Pkwy, San Antonio, Texas |
| Authorized Official Name and Position | Brian K Macgillivray (OWNER) |
| Authorized Official Contact | 2106159990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grey Canyon Family Medicine Pa 20658 Stone Oak Pkwy Ste 108 San Antonio TX 78258 Ph: (210) 615-9990 | Grey Canyon Family Medicine Pa 20658 Stone Oak Pkwy Ste 108 San Antonio TX 78258 Ph: (210) 615-9990 |
| NPI Number | 1043391121 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043391121 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M3304 (Texas) | Primary |
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