Provider Demographics
NPI:1871848242
Name:GRIDER, ABBY MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ABBY
Middle Name:MARIE
Last Name:GRIDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ABBY
Other - Middle Name:MARIE
Other - Last Name:RARDIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:231 S COLLINS RD
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-4624
Mailing Address - Country:US
Mailing Address - Phone:972-892-3970
Mailing Address - Fax:
Practice Address - Street 1:231 S COLLINS RD
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-4624
Practice Address - Country:US
Practice Address - Phone:972-892-3970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA122183207Q00000X
TXR4709207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine