Susan Leslie Granville, PA
NPI #1912104431 in Georgetown, Texas
Provider Information
- NPI Number
- 1912104431
- Entity Type
- Individual
- Name
- Susan Leslie Granville, PA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physician Assistant - Medical
- Credential
- PA
- Enumeration Date
- Jun 28, 2007
- Last Updated
- Apr 18, 2011
Practice Location
- Address
- 4945 WILLIAMS DR
- City
- Georgetown
- State
- Texas
- ZIP Code
- 78633-2008
- Phone
- (512) 819-0500
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Medical — Medical |
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