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Individual

DR. JEFFERY G GRIGSBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
4109 N MIDLAND DR, MIDLAND, TX 79707-3500
(432) 694-5259
(432) 694-7694
Mailing address
4109 N MIDLAND DR, MIDLAND, TX 79707-3500
(432) 694-5259
(432) 694-7694

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3040TG
TX
152WC0802X
Corneal and Contact Management Optometrist
3040TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
130998102
TX
01
3040TG
OPTOMETRY LICENSE
TX
Enumeration date
08/19/2005
Last updated
07/01/2014
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