Provider Demographics
NPI:1902097611
Name:GRANITE KEEPHOLDINGS, INC.
Entity Type:Organization
Organization Name:GRANITE KEEPHOLDINGS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HONG
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-541-6988
Mailing Address - Street 1:7447 HARWIN DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7447 HARWIN DR
Practice Address - Street 2:SUITE 107
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036
Practice Address - Country:US
Practice Address - Phone:713-541-6988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty