Organization
LAKE RAY HUBBARD PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID PHILLIP GRANGER MD (OWNER/PEDIATRICIAN)
(972) 412-3034
Entity
Organization
Contact information
Practice address
9100 LAKEVIEW PKWY, ROWLETT, TX 75088-4537
(972) 412-3034
Mailing address
9100 LAKEVIEW PKWY, ROWLETT, TX 75088-4537
(972) 412-3034
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G9107
TX
Other
Enumeration date
08/14/2006
Last updated
08/22/2020
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