Provider Demographics
NPI:1215156542
Name:GREWAL, PRABHDEEP KAUR (MD)
Entity type:Individual
Prefix:DR
First Name:PRABHDEEP
Middle Name:KAUR
Last Name:GREWAL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:400 CONCORD PLAZA DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6905
Mailing Address - Country:US
Mailing Address - Phone:210-804-5400
Mailing Address - Fax:210-678-4142
Practice Address - Street 1:11212 SATE HIGHWAY 151
Practice Address - Street 2:SUITE 150
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4505
Practice Address - Country:US
Practice Address - Phone:210-804-5990
Practice Address - Fax:210-804-5994
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2021-07-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0070805207LP2900X
WI63674-20207LP2900X
IL036.122514390200000X
AR390200000X
TXQ8067207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX529187YLLUMedicare PIN
DC193349YAOZMedicare PIN