Individual
DR. JEANNINE L. GRIFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 NORTH VIRGINIA, PORT LAVACA, TX 77979
(361) 552-6721
(361) 552-7463
Mailing address
1200 NORTH VIRGINIA, PORT LAVACA, TX 77979
(361) 552-6721
(361) 552-7463
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G5119
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113513502
GROUP MEDICAID NUMBER
TX
05
—
118203202
—
TX
01
—
ZOO0H160
GROUP MEDICARE NUMBER
TX
Enumeration date
06/23/2006
Last updated
05/22/2014
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