SUSAN LESLIE GRANVILLE

GEORGETOWN, TX
NPI1912104431
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: TX  PA06979)
Enumeration Date2007-06-28
Last Update Date2011-04-18
Business Address
-- SUSAN LESLIE GRANVILLE PA
4945 WILLIAMS DR
GEORGETOWN, TX 78633-2008
Phone number: 512-819-0500
Mailing Address
-- SUSAN LESLIE GRANVILLE PA
626 APACHE MOUNTAIN LN
GEORGETOWN, TX 78633-5434
Phone number: 512-943-9847
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