GRANBURY FAMILY MED CLINIC
NPI 1396934147
Clinic/Center - Primary Care in Granbury, TX
About Granbury Family Med Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GRANBURY FAMILY MED CLINIC (NPI 1396934147) is a healthcare organization registered as a primary care in Granbury, Texas and active in the NPI registry since October 2007. The organization holds a CLIA Microscopy certificate valid through March 12, 2027 and lists Robert Louis Lee, Physician/owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Granbury Family Med Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Granbury Family Med Clinic, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate for Provider-Performed Microscopy Procedures (PPMP) 45D0984068
Granbury Family Medclinic PA · Granbury, TXFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Granbury Family Med Clinic's NPI number?
The NPI number for Granbury Family Med Clinic is 1396934147. It was assigned to this organization in the NPPES registry on October 17, 2007.
Where is Granbury Family Med Clinic located?
Granbury Family Med Clinic is located at 1200 Crawford Ave Ste A, Granbury, TX 76048. The listed phone number is (817) 573-3447.
What is Granbury Family Med Clinic's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Granbury Family Med Clinic enrolled in Medicare?
Yes. Granbury Family Med Clinic is registered in the Medicare PECOS enrollment system.
When is Granbury Family Med Clinic's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Texas, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Granbury Family Med Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Granbury Family Med Clinic. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Granbury Family Med Clinic hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 45D0984068) is associated with this NPI, valid through March 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Granbury Family Med Clinic was last updated on June 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Granbury Family Med Clinic · NPI 1396934147
Primary Care organization in Granbury, Texas. Organization record, active in the CMS NPPES registry since October 17, 2007.
## Identity
- **NPI:** 1396934147 (Entity type: Organization)
- **Enumerated:** October 17, 2007
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Robert Lee, PHYSICIAN/OWNER
## Practice location
- **Address:** 1200 CRAWFORD AVE STE A, Granbury, TX 76048-4560
- **Phone:** (817) 573-3447 · **Fax:** (817) 573-3616
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Texas, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 3, 2026
- **Other identifiers:** Medicaid 145044701 (TX)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1396934147) · Data from the CMS NPPES public registry.