Granite Anesthesia

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

Legal business name

GRANITE ANESTHESIA

Doing business as

Granite Clinical Services

Practice address

2915 W Bitters Rd Ste 201
San Antonio, TX 78248-2007

Phone

(210) 598-4262

NPI assigned

Nov 15, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Roxanna Laroque

Title

Client Experience Manager

Phone

(210) 598-2800

Specialties & licenses 6

Addresses

Other names 1

• Granite Clinical Services Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lance Elliot Jackson, M.D., F.A.C.S.

  • Otology & Neurotology Physician
  • San Antonio, TX
  • NPI 1174554521
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705449600000",
    "number": "1548773203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 W BITTERS RD STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782482007",
            "telephone_number": "210-598-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 W BITTERS RD STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782482007",
            "telephone_number": "210-598-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANITE ANESTHESIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-15",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A",
        "authorized_official_last_name": "LAROQUE",
        "authorized_official_first_name": "ROXANNA",
        "authorized_official_title_or_position": "CLIENT EXPERIENCE MANAGER",
        "authorized_official_telephone_number": "210-598-2800"
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Electrodiagnostic Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "246ZE0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Granite Clinical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark C. Granberry, PHARM.D.
• Ramona Granda-Rodriguez, MD
• Mark Granda
• Grandview of Westover Hills LLC
• Lara Alayna Granger, NP
• Andrea Joy Grant-Vermont, MD
• Adela Annette Grant, MSN, APRN, NNP-BC
• Andrine K Grant, M.D.
• Courtney Dewitt Grant, APRN-CNP
• Darren Lamont Grant Jr.

• Clinical Neurophysiology Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Clinical Neurophysiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.