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Organization

LAKE GRANBURY HOSPITAL-BASED PROFESSIONAL SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WENDI KEETON (SR. DIRECTOR, OPERATIONS)
(877) 892-9815
Entity
Organization

Contact information

Practice address
1310 PALUXY RD, GRANBURY, TX 76048-5655
(817) 573-2273
Mailing address
PO BOX 680060, FRANKLIN, TN 37068-0060
(877) 848-1457
(659) 235-6176

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
207P00000X
Emergency Medicine Physician
Primary
208M00000X
Hospitalist Physician
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner
367500000X
Certified Registered Nurse Anesthetist

Other

Enumeration date
12/21/2023
Last updated
01/20/2025
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