Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Grant Charles Richardson, PA-C

Individual provider Physician Assistant · NPI 1255221073

Grant Charles Richardson, PA-C is a Physician Assistant in San Antonio, Texas. Qualified in 2022, 4 years ago. Practices with Banner Physician Specialists Arizona LLC, a 372-clinician group and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1318 Mesa Draw
San Antonio, TX 78258-2623
Phone: (850) 252-3344
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1255221073
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJuly 3, 2025
Last updated in NPPESJuly 3, 2025
Certification dateJuly 3, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Banner Physician Specialists Arizona Llc — 372 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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