Provider Demographics
NPI:1134390545
Name:CURT G. GRIFFIS, D.P.M.
Entity type:Organization
Organization Name:CURT G. GRIFFIS, D.P.M.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CURT
Authorized Official - Middle Name:G
Authorized Official - Last Name:GRIFFIS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:956-727-8605
Mailing Address - Street 1:1302 HENDRICKS AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-5217
Mailing Address - Country:US
Mailing Address - Phone:956-727-8605
Mailing Address - Fax:956-727-0652
Practice Address - Street 1:1302 HENDRICKS AVE STE 2
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-5217
Practice Address - Country:US
Practice Address - Phone:956-727-8605
Practice Address - Fax:956-727-0652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0636213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX018701501Medicaid
TX3965600001Medicare NSC
TX00FA82Medicare PIN
TXT13571Medicare UPIN