SUSAN LESLIE GRANVILLE (NPI# 1912104431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912104431 |
| Entity Type | Individual |
| Full Name | SUSAN LESLIE GRANVILLE |
| Credential | PA |
| Practice Address |
4945 Williams Dr Georgetown TX 78633-2008 |
| Mailing Address |
626 Apache Mountain Ln Georgetown TX 78633-5434 |
| Practice Telephone | 5128190500 |
| Mailing Telephone | 5129439847 |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2011-04-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA06979 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4945 WILLIAMS DR |
| City | GEORGETOWN |
| State | TX |
| Zip Code | 78633-2008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659352680 | John E Carlson | Internal Medicine | 4945 Williams Dr, Georgetown, TX 78633-2008 | 2005-11-08 |
| 1245752369 | Wendy Tsao | Social Worker | 4945 Williams Dr, Georgetown, TX 78633-2008 | 2017-07-11 |
| 1407388531 | Hope Fuller | Internal Medicine | 4945 Williams Dr, Georgetown, TX 78633-2008 | 2017-03-29 |
| 1821454745 | Jennifer Marie Medina | Social Worker | 4945 Williams Dr, Georgetown, TX 78633-2008 | 2016-01-07 |
| 1356740856 | Ashton Schutza | Physician Assistant | 4945 Williams Dr, Georgetown, TX 78633-2008 | 2014-08-20 |
| 1386072494 | Parisa Amirabadi | Physician Assistant | 4945 Williams Dr, Georgetown, TX 78633-2008 | 2013-10-29 |
| 1225471188 | Zayd Luay Abdullah Al-nouri | Internal Medicine | 4945 Williams Dr, Georgetown, TX 78633-2008 | 2013-04-10 |
| 1609132711 | Nupur Jhawar | Internal Medicine | 4945 Williams Dr, Georgetown, TX 78633-2008 | 2012-04-03 |
| 1255629960 | Joseph Cessac | Optometrist | 4945 Williams Dr, Georgetown, TX 78633-2008 | 2011-07-14 |
| 1124319819 | Sadia Rashid | Internal Medicine | 4945 Williams Dr, Georgetown, TX 78633-2008 | 2011-04-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568098937 | Medsur One Telemedicine LLC | Nurse Practitioner | 110 Eisenhower Court (administrative Office Location), 1309 Coffeen Ave Ste 1200 Sheridan Wy 82801, Georgetown, TX 78633 | 2020-03-18 |
| 1467946384 | Majestic Healthcare, Pllc | Nurse Practitioner | 110 Eisenhower Ct, Georgetown, TX 78633 | 2018-06-15 |
| 1912419649 | Randalls Food & Drugs Lp | Durable Medical Equipment & Medical Supplies | 5721 Williams Dr, Georgetown, TX 78633 | 2017-11-03 |
| 1255783510 | Peter James Mcgrath | Physical Therapist | 4749 Williams Drive, Suite 335, Georgetown, TX 78633 | 2016-07-11 |
| 1316357346 | Cody Ryon Gomez | Internal Medicine | 3201 South Austin Ave, Suite 205, Georgetown, TX 78633 | 2014-04-29 |
| 1902130701 | Don Wayne Berry | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 624 Rio Grand Loop, Georgetown, TX 78633 | 2009-09-25 |
| 1851567499 | Georgetown Pediatric Dentistry, LLC | Dentist | 4507 Williams Drive, Georgetown, TX 78633 | 2008-05-04 |
| 1215035845 | Saramma George | Family Medicine | 105 Wildwood Drive, Suite 105, Georgetown, TX 78633 | 2006-09-20 |
| 1104834258 | Mobile Cr Imaging, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 4749 Williams Dr, Georgetown, TX 78633 | 2006-08-04 |
| 1619997350 | Kathryn E Holland | Counselor | 603 Chambers Creek Ct, Georgetown, TX 78633 | 2006-07-19 |
| Find all providers in zip 78633 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437704921 | Daniel Lee Mullins | Physician Assistant | 122 Travis Way, Georgetown, KY 40324-0500 | 2019-08-02 |
| 1629533310 | Michelle Ladanyi | Physician Assistant | 1140 Lexington Rd Ste 102, Georgetown, KY 40324-9330 | 2019-02-06 |
| 1154460400 | Marcy Bradley | Physician Assistant | 26026 Patriots Way, Georgetown, DE 19947-2584 | 2007-02-05 |
| 1225094519 | Catherine Gulley | Physician Assistant | 111 Osbourne Way, St 101, Georgetown, KY 40324-8004 | 2006-04-25 |
| 1952386906 | Julie Neighbors | Physician Assistant | 2116 Scenic Dr, Georgetown, TX 78626-7728 | 2005-12-13 |
| 1730533209 | Georgetown Internal Medicine | Physician Assistant | 1138 Lexington Rd, Suite 290, Georgetown, KY 40324-9672 | 2016-04-20 |
| 1851796775 | Samantha A Graef | Physician Assistant | 3201 S Austin Ave, Suite 210, Georgetown, TX 78626-7545 | 2014-11-04 |
| 1679803381 | Josie Ann Gast | Physician Assistant | 631 E State St, Georgetown, OH 45121-1437 | 2009-12-31 |
| 1477673804 | Steven Don Mickelson | Physician Assistant | 1900 Scenic Dr, Suite 3308, Georgetown, TX 78626-7724 | 2007-03-30 |
| 1568480382 | Kimberly Foster | Physician Assistant | 1138 Lexington Rd, Suite 130, Georgetown, KY 40324-9672 | 2006-07-18 |
| Find all providers in GEORGETOWN | ||||
| City | GEORGETOWN |
| Zip Code | 78633 |
Please comment or provide details below to improve the information on SUSAN LESLIE GRANVILLE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.