Provider Demographics
NPI:1568854032
Name:GRIGGS, NELDA
Entity Type:Individual
Prefix:
First Name:NELDA
Middle Name:
Last Name:GRIGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 N HAMPTON RD # 302
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-4920
Mailing Address - Country:US
Mailing Address - Phone:866-290-3790
Mailing Address - Fax:866-290-3790
Practice Address - Street 1:512 N HAMPTON RD # 302
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4920
Practice Address - Country:US
Practice Address - Phone:866-290-3790
Practice Address - Fax:866-290-3790
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment