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MELINDA DOLORES GRIJALVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
1975 N VETERANS BLVD STE 5, EAGLE PASS, TX 78852-4456
(830) 773-9449
(830) 757-3142
Mailing address
1975 N VETERANS BLVD STE 5, EAGLE PASS, TX 78852-4456
(830) 773-9449
(830) 757-3142

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
230790
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
230790
RN
TX
01
8N3345
BC/BS INDIVIDUAL NUMBER
TX
Enumeration date
09/16/2006
Last updated
07/09/2007
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