Provider Demographics
NPI:1619954187
Name:GRIMES, MARGARET S (CRNA)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:S
Last Name:GRIMES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:GRIMES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:714 FM 1960 RD W
Mailing Address - Street 2:SUITE 206
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-3405
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4120 SOUTHWEST FWY
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7339
Practice Address - Country:US
Practice Address - Phone:713-355-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX249403367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83745UOtherBCBS