LAKE RAY HUBBARD PEDIATRICS
NPI 1427061308
Pediatrics in Rowlett, TX

Q: What is Lake Ray Hubbard Pediatrics's NPI number?

The NPI number for Lake Ray Hubbard Pediatrics is 1427061308. It was assigned to this organization in the NPPES registry on August 14, 2006.

Q: What is Lake Ray Hubbard Pediatrics's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since August 14, 2006CLIA 45D0477909 · Waiver

9100 LAKEVIEW PKWY, ROWLETT, TX 75088(972) 412-3034 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Lake Ray Hubbard Pediatrics NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE RAY HUBBARD PEDIATRICS (NPI 1427061308) is a healthcare organization registered as a pediatrics in Rowlett, Texas and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through December 17, 2026 and lists David Phillip Granger, Owner/pediatrician, as its authorized official.

NPPES Registry Identity

NPI1427061308

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameLAKE RAY HUBBARD PEDIATRICS

Location Address9100 LAKEVIEW PKWYRowlett, TX 75088-4537

Mailing Address9100 Lakeview PkwyRowlett, TX 75088-4537 · (972) 412-3034

Phone(972) 412-3034

Organization SubpartNo

Authorized OfficialDavid Phillip GrangerOwner/pediatrician · (972) 412-3034

Enumeration DateAugust 14, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1427061308 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in TX · G9107

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

9100 LAKEVIEW PKWY, Rowlett, TX 75088

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 of Waiver 45D0477909

Lake Ray Hubbard Pediatric Clinic · Rockwall, TX

Active · expires Dec 17, 2026

CLIA Number45D0477909

Laboratory TypePhysician Office

Certificate Effective DateDecember 18, 2024

Certificate Expiration DateDecember 17, 2026

Laboratory DirectorSusan Smart

Laboratory Phone(972) 412-3034

Laboratory LocationLake Ray Hubbard Pediatric Clinic862 W Rusk St, Rockwall, TX 75087

CLIA data matches this NPI record on: Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CALLIE KINSLEY CPNP

Nurse Practitioner (Pediatrics)