Individual
DAVID B GRISSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-1100
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 920-7340
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K7547
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111903406
—
TX
01
—
8J9055
BCBS
TX
01
—
P00312850
RAILROAD MEDICARE
TX
Enumeration date
03/16/2006
Last updated
09/10/2025
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