Individual
KELLYE MICHELLE GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4430 E HIGHWAY 287 STE 100, MIDLOTHIAN, TX 76065-5576
(972) 723-5590
(972) 723-5592
Mailing address
2665 SCRIPTURE ST, DENTON, TX 76201-2302
(940) 387-8763
(940) 535-5901
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA08921
TX
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
01/30/2014
Last updated
07/25/2022
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