Provider Demographics
NPI:1699110023
Name:GRANT, ELISABETH LEMOYNE (MD)
Entity type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:LEMOYNE
Last Name:GRANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LIZ
Other - Middle Name:LEMOYNE
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1901 N. MACARTHUR BLVD
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-2220
Mailing Address - Country:US
Mailing Address - Phone:972-579-8110
Mailing Address - Fax:
Practice Address - Street 1:1901 N MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2220
Practice Address - Country:US
Practice Address - Phone:972-579-8110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6921207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine