Basic Information
| Provider Information | |||||||||
| NPI: | 1356726376 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRUBBS | ||||||||
| FirstName: | SHAWN | ||||||||
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| Credential: | ARDMS, RVT, RDCS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16620 N US HIGHWAY 281 | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782322327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106141231 | ||||||||
| FaxNumber: | 2106160704 | ||||||||
| Practice Location | |||||||||
| Address1: | 16620 US HWY 281N | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106141231 | ||||||||
| FaxNumber: | 2106160704 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2015 | ||||||||
| LastUpdateDate: | 02/15/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246XS1301X | Y | Technologists, Technicians & Other Technical Service Providers | Spec/Tech, Cardiovascular | Sonography |
No ID Information.