Provider Demographics
NPI:1548494040
Name:GRUBBS, CHRISTINA DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:DANIEL
Last Name:GRUBBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:CHRISTINA
Other - Middle Name:ADRIANE
Other - Last Name:DANIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:328 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-3866
Mailing Address - Country:US
Mailing Address - Phone:972-436-7557
Mailing Address - Fax:972-221-8246
Practice Address - Street 1:328 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3866
Practice Address - Country:US
Practice Address - Phone:972-436-7557
Practice Address - Fax:972-221-8246
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10033773207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX538393OtherPHYSICIAN IN TRAINING PERMIT ID NUMBER