# GRANBERRY MEDICAL CARE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679075493
- **Authorized official:** DR. RAUL GUILLERMO LOPEZ VALLE MD (OWNER/STAFF PHYSICIAN)
- **Authorized official phone:** (281) 973-8049

## Contact information

- **Practice address:** 900 GRANBERRY ST, HUMBLE, TX 77338-4757
- **Practice address phone:** (281) 973-8049
- **Practice address fax:** (281) 570-2943
- **Mailing address:** 900 GRANBERRY ST, HUMBLE, TX 77338-4757
- **Mailing address phone:** (281) 973-8049
- **Mailing address fax:** (281) 973-8049

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/07/2018
- **Last updated:** 03/07/2018