Provider Demographics
NPI:1760115802
Name:GRANBURY 2300 OPCO LLC
Entity Type:Organization
Organization Name:GRANBURY 2300 OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:FINLAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-415-9910
Mailing Address - Street 1:1001 BRICKELL BAY DR STE 1504
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-4938
Mailing Address - Country:US
Mailing Address - Phone:305-415-9910
Mailing Address - Fax:
Practice Address - Street 1:2300 PALUXY HWY
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-5531
Practice Address - Country:US
Practice Address - Phone:817-776-4362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No177F00000XOther Service ProvidersLodging