Provider Demographics
NPI:1144531955
Name:ALICIA W. GROSSMANN, MD, PA
Entity type:Organization
Organization Name:ALICIA W. GROSSMANN, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:W
Authorized Official - Last Name:GROSSMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-834-9999
Mailing Address - Street 1:6301 W PARMER LN
Mailing Address - Street 2:SUITE 102
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-6801
Mailing Address - Country:US
Mailing Address - Phone:512-834-9999
Mailing Address - Fax:512-834-9998
Practice Address - Street 1:6301 W PARMER LN
Practice Address - Street 2:SUITE 102
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-6801
Practice Address - Country:US
Practice Address - Phone:512-834-9999
Practice Address - Fax:512-834-9998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1660207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty