Individual
DR. RONALD GRIMWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
(254) 724-7603
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
H5891
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1178535-05
—
TX
01
—
1178535-06
CSHCN
TX
01
—
8S0398
BLUE SHIELD
TX
Enumeration date
03/25/2006
Last updated
12/09/2021
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