Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | H2412 | TX |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | H2412 | TX |
NPI | 1134162605 |
---|---|
Provider Name | William Malcolm Granberry |
First Address | Houston, TX 77030-2312 |
Second Address | Houston, TX 77030-2312 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 14/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1371569-05 | (05) | TX |
200016150 | MEDICARE RAILROAD (01) | TX |
4105814 | AETNA/US HEALTHCARE (01) | TX |
6570151 | CIGNA (01) | TX |
741660214 | HEALTH NEW ENGLAND (01) | TX |
843087 | BCBS OF TEXAS (01) | TX |
E32881 | (02) | TX |