Individual
PAUL JEFFREY GRIMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4055 VALLEY VIEW LN, DALLAS, TX 75244-5074
(855) 984-5121
Mailing address
4055 VALLEY VIEW LN STE 700, DALLAS, TX 75244-5045
(855) 984-5121
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
059916
GA
207Q00000X
Family Medicine Physician
200000810
NC
207R00000X
Internal Medicine Physician
200000810
NC
208D00000X
General Practice Physician
Primary
200000810
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003174806A
—
GA
01
—
1278M
BCBSNC
NC
01
—
202I086108
MEDICARE PTAN
GA
05
—
7906805
—
NC
Enumeration date
02/22/2006
Last updated
11/14/2025
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