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General NPI Number Information
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NPI Number | 1538873682
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Entity Type | Individual
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Provider Name | LAUREN GROFF
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Gender | Female
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Dates
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Enumeration Date | 01/12/2023
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 3705 W 15TH ST
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City | PLANO
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State | TX
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Zip | 75075-7753
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Country | US
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Telephone | 972-867-3577
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Fax |
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Provider Business Mailing Address
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Address Line | 10903 CROMWELL DR
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City | DALLAS
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State | TX
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Zip | 75229-3868
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Country | US
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Telephone | 512-217-4102
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1107025
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License Number State | TX
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