Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ebt Holdings of Georgia Incorporated

Organization Family Medicine Physician · NPI 1871287250

Ebt Holdings of Georgia Incorporated is a Family Medicine Physician in Lawrenceville, Georgia. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

1430 Five Forks Trickum Rd Ste 220
Lawrenceville, GA 30044-8183
Phone: (786) 352-7021
Fax: (786) 698-1632
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1871287250
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Enrique Massuet Valdes — Vice President · (786) 352-7021
NPI enumeratedJune 7, 2023
Last updated in NPPESDecember 5, 2023
Certification dateDecember 5, 2023
Mailing address1430 Five Forks Trickum Rd Ste 220, Lawrenceville, GA 30044-8183

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