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Organization

ELEVATE SENIORS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DEBORAH RUTH LANIER NP (NURSE PRACTITIONER)
(214) 558-8730
Entity
Organization

Contact information

Practice address
1452 HUGHES RD, GRAPEVINE, TX 76051-7366
(817) 873-5105
Mailing address
406 CLAYTON ST, GRAND PRAIRIE, TX 75052-3322
(214) 558-8730

Taxonomy

Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
236933
TX

Other

Enumeration date
07/15/2015
Last updated
07/15/2015
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