Provider Demographics
NPI:1225249998
Name:LAGRONE, HOWARD ALAN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:ALAN
Last Name:LAGRONE
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S MAIN ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-5382
Mailing Address - Country:US
Mailing Address - Phone:817-410-4722
Mailing Address - Fax:817-410-4723
Practice Address - Street 1:601 S MAIN ST
Practice Address - Street 2:SUITE 209
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-5382
Practice Address - Country:US
Practice Address - Phone:817-410-4722
Practice Address - Fax:817-410-4723
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG35382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122359606Medicaid
TX8X5115OtherBCBS
TX8L2018Medicare PIN
TX8X5115OtherBCBS