Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | P7640 | TX |
Y | 2080P0205X | Pediatric Endocrinologist | P7640 | TX |
NPI | 1154616068 |
---|---|
Provider Name | Hector Manuel Granados |
First Address | El Paso, TX 79902 |
Second Address | El Paso, TX 79938-2609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2011 |
Last Update Date | 10/08/2020 |