Organization · Type 2 NPI
Lakeshore Ent
Facial Plastic Surgery Physician · Granbury, TX
NPI number
1003096991
Active
Practice location
1305 Paluxy Rd, Suite A
Granbury, TX 76048-5641
Fax (817) 573-9783
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Facial Plastic Surgery Physician Primary | 207YS0123X | K8272 (TX) |
Facial Plastic Surgery Physician: An otolaryngologist who specializes in facial plastic surgery.
3 other providers at this address
About NPI 1003096991
Lakeshore Ent's National Provider Identifier is 1003096991, issued on Nov 7, 2007. The primary taxonomy on file is Facial Plastic Surgery Physician (207YS0123X), and the practice location is in Granbury, TX. The record was last updated on Aug 15, 2025.