Provider Demographics
NPI:1710325592
Name:VIRTUE, GRISSELD R (RMT,CLT-LANA)
Entity Type:Individual
Prefix:MS
First Name:GRISSELD
Middle Name:R
Last Name:VIRTUE
Suffix:
Gender:F
Credentials:RMT,CLT-LANA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 ZORA ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-5352
Mailing Address - Country:US
Mailing Address - Phone:713-927-4044
Mailing Address - Fax:
Practice Address - Street 1:4141 SOUTHWEST FWY
Practice Address - Street 2:SUITE 315
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7313
Practice Address - Country:US
Practice Address - Phone:713-623-4247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT015167174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist