Physician Compare National (NPI:1306049606)

HEALTHCARE PROVIDER: LAFAINE MARIE GRANT MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1306049606
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9739270919
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070801000754
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GRANT
	Individual professional last name
Provider First Name	LAFAINE
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1997
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GASTROENTEROLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GASTROENTEROLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0648188250
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2129
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	5323 HARRY HINES BLVD
	Group Practice or individual's line 1 address
City	DALLAS
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	753907208
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450044
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	UT SOUTHWESTERN UNIVERSITY HOSPITAL - WILLIAM P. CLEMENTS JR.
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450015
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PARKLAND HEALTH & HOSPITAL SYSTEM
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y