LAKE GRANBURY INTERNAL MEDICINE & PEDIATRICS, PA – NPI #1972608636
Internal Medicine

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

LAKE GRANBURY INTERNAL MEDICINE & PEDIATRICS, PA is a provider located in GRANBURY, TX. NPPES has assigned the NPI number 1972608636 to LAKE GRANBURY INTERNAL MEDICINE & PEDIATRICS, PA on September 14, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207R00000X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine.

The NPI profile was previously updated about 12 years ago on Apr 02, 2014. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LAKE GRANBURY INTERNAL MEDICINE & PEDIATRICS, PA below.

NPI Profile for
LAKE GRANBURY INTERNAL MEDICINE & PEDIATRICS, PA

NPI Number
1972608636
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LAKE GRANBURY INTERNAL MEDICINE & PEDIATRICS, PA
Primary location
2005 ROCKVIEW DRIVE
GRANBURY, TX 76049
Phone: (817) 579-1005 Fax: (817) 579-1093
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
PENELOPE JACKSON
PHYSICIAN/OWNER
Phone: (817) 579-1005
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207R00000X
- Internal Medicine (Primary)
208000000X
- Pediatrics

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.