Individual
DR. C. KEITH GRISHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3108 MIDWAY RD, SUITE #200, PLANO, TX 75093-6383
(972) 781-1515
(972) 781-1313
Mailing address
3108 MIDWAY RD, SUITE #200, PLANO, TX 75093-6383
(972) 781-1515
(972) 781-1313
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
K9791
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030393501
—
TX
Enumeration date
07/27/2007
Last updated
10/31/2008
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