Individual
JUAN CARLOS GRANADOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSA
Contact information
Practice address
5808 MANHATTAN DR, FORT WORTH, TX 76107-7613
(214) 227-2457
(214) 764-0880
Mailing address
PO BOX 2550, ROWLETT, TX 75030-2550
(214) 227-2457
(214) 764-0880
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
139944
CO
246ZC0007X
Surgical Assistant
Primary
SA00889
TX
Other
Enumeration date
03/12/2013
Last updated
06/27/2022
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