Grant W Mallory, MD - Medicare Neurosurgery in Fort Sam Houston, TX

Grant W Mallory, MD is a medicare enrolled "Neurological Surgery" physician in Fort Sam Houston, Texas. He went to Georgetown University School Of Medicine and graduated in 2009 and has 15 years of diverse experience with area of expertise as Neurosurgery. He is a member of the group practice Acute Care Surgical Affiliates Of Texas Pa, Mayo Clinic Health System-northwest Wisconsin Region Inc and his current practice location is 3551 Roger Brooke Dr, Fort Sam Houston, Texas. You can reach out to his office (for appointments etc.) via phone at (210) 916-3482.

Grant W Mallory is licensed to practice in Minnesota (license number 53091) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1568690477.

Contact Information

Grant W Mallory, MD
3551 Roger Brooke Dr,
Fort Sam Houston, TX 78234-4504
(210) 916-3482
Not Available



Physician's Profile

Full NameGrant W Mallory
GenderMale
SpecialityNeurosurgery
Experience15 Years
Location3551 Roger Brooke Dr, Fort Sam Houston, Texas
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Grant W Mallory attended and graduated from Georgetown University School Of Medicine in 2009
  NPI Data:
  • NPI Number: 1568690477
  • Provider Enumeration Date: 06/30/2009
  • Last Update Date: 03/28/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 4284829565
  • Enrollment ID: I20180427001227

Medical Identifiers

Medical identifiers for Grant W Mallory such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1568690477NPI-NPPES
ENROLLEDMedicaidMN
ENROLLEDMedicaidIA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207T00000XNeurological Surgery 81713 (Wisconsin)Secondary
207T00000XNeurological Surgery 100503 (Wisconsin)Secondary
207T00000XNeurological Surgery 53091 (Minnesota)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Mayo Clinic Health System Eau Claire HospitalEau claire, WIHospital
Christus Spohn Hospital Corpus ChristiCorpus christi, TXHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Acute Care Surgical Affiliates Of Texas Pa993144648120
Mayo Clinic Health System-northwest Wisconsin Region Inc4385553627623

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Grant W Mallory allows following entities to bill medicare on his behalf.
Entity NameProvidence Health Alliance
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1932210838
PECOS PAC ID: 6305731068
Enrollment ID: O20040220000307

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Entity NameNeurosurgical Associates Of San Antonio, P.a.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1447295753
PECOS PAC ID: 9638151954
Enrollment ID: O20040602000176

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Entity NameAcute Care Surgical Affiliates Of Texas Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1407322415
PECOS PAC ID: 9931446481
Enrollment ID: O20190123000295

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Entity NameNeurosurgical Affiliates Of Texas Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1437935137
PECOS PAC ID: 1153779137
Enrollment ID: O20231201000598

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Grant W Mallory is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Grant W Mallory, MD
6401 France Avenue South,
Edina, MN 55435-2104

Ph: (612) 672-2294
Grant W Mallory, MD
3551 Roger Brooke Dr,
Fort Sam Houston, TX 78234-4504

Ph: (210) 916-3482

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Neurological Surgery Doctors in Fort Sam Houston, TX

Dr. Ian S. Mcdougall, M.D.
Neurological Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234
Phone: 210-539-9582    
Geoffrey William Peitz, MD
Neurological Surgery
Medicare: Medicare Enrolled
Practice Location: 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234
Phone: 210-916-3482    
Victor Sabourin,
Neurological Surgery
Medicare: Medicare Enrolled
Practice Location: 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234
Phone: 210-539-9582    
Ryan Patrick Morton, M.D.
Neurological Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234
Phone: 574-847-9065    

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