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General NPI Number Information
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NPI Number | 1962398461
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Entity Type | Organization
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Legal Business Name | GRANITE DME, LLC
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Dates
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Enumeration Date | 06/13/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 3246 PRESTON RD STE 620
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City | FRISCO
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State | TX
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Zip | 75034-9077
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Country | US
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Telephone | 469-750-9971
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Fax | 214-291-2648
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Provider Business Mailing Address
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Address Line | 14932 ROLLOVER PASS LN
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City | FRISCO
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State | TX
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Zip | 75035-1256
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Country | US
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Telephone | 469-750-9971
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Fax | 214-291-2648
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Authorized Official
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Title or Position | OWNER
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Name | BRANDON WOODS
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Credential |
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Telephone | 469-750-9971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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