Mark C. Grant, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

0025191 Issued in TX

Legal business name

MARK C. GRANT, PLLC

Practice address

4613 W Orem Dr
Houston, TX 77045-4107

Phone

(713) 433-4344

Fax

(713) 433-1814

NPI assigned

Jun 23, 2014

Organization subpart

No

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

Authorized official

Name

Debra Lanfer

Title

Office Manager

Phone

(713) 433-4344

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403481600000",
    "number": "1851706444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4613 W OREM DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770454107",
            "telephone_number": "713-433-4344",
            "fax_number": "713-433-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4613 W OREM DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770454107",
            "telephone_number": "713-433-4344",
            "fax_number": "713-433-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK C. GRANT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-06-23",
        "status": "A",
        "authorized_official_last_name": "LANFER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "713-433-4344"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "0025191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209997001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Houston, TX
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; 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.