Provider Demographics
NPI:1134389539
Name:DR. KEVIN D GRIMES P.A.
Entity type:Organization
Organization Name:DR. KEVIN D GRIMES P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:GRIMES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-442-3966
Mailing Address - Street 1:703 E FM 544
Mailing Address - Street 2:SUITE 170
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4028
Mailing Address - Country:US
Mailing Address - Phone:972-442-3699
Mailing Address - Fax:972-429-1989
Practice Address - Street 1:703 E FM 544
Practice Address - Street 2:SUITE 170
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4028
Practice Address - Country:US
Practice Address - Phone:972-442-3699
Practice Address - Fax:972-429-1989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10842111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty