Provider Demographics
NPI:1194861674
Name:GROVER, DAVINDER (MD, MPH)
Entity Type:Individual
Prefix:
First Name:DAVINDER
Middle Name:
Last Name:GROVER
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 730475
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-0475
Mailing Address - Country:US
Mailing Address - Phone:214-360-0000
Mailing Address - Fax:214-360-0083
Practice Address - Street 1:10740 N CENTRAL EXPY
Practice Address - Street 2:SUITE 300
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2161
Practice Address - Country:US
Practice Address - Phone:214-360-0000
Practice Address - Fax:214-360-0083
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2011-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP19720207W00000X
FLME 104159207W00000X
TXN6331207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology