Granbury Pediatrics & Associates

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

K6711 Issued in TX

Legal business name

GRANBURY PEDIATRICS & ASSOCIATES

Practice address

805 Paluxy Rd
Granbury, TX 76048-2329

Phone

(817) 579-8687

NPI assigned

May 8, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Michelle Calcote

Title

Office Manager

Phone

(817) 579-8687

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700099207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 PALUXY RD",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760482329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 PALUXY RD",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760482329",
            "telephone_number": "817-579-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANBURY PEDIATRICS & ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CALCOTE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "817-579-8687",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K6711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "82942Y",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7240025",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026584",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SCOTT & WHITE",
            "identifier": "276279",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Granbury II Enterprises, LLC (The Oaks of Granbury)
• Granbury Internal Medicine Associates, PC
• Granbury Isd
• Granbury Massage and Wellness
• Granbury Park Dental GPS PLLC
• Granbury SNF LLC (Granbury Rehab & Nursing)
• Granbury Spine and Sports Center, LLC
• Granbury Surgical Plaza
• Grandbury Dental , PLLC
• Kenneth Gray, DDS

• Pediatrics Physician in Granbury, TX
• Providers in Granbury, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.