Healthcare Provider Details

I. General information

NPI: 1659466118
Provider Name (Legal Business Name): DARRELL ALTON GRIFFIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 01/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2171 SILVER MOON TRAIL
CROSBY TX
77532
US

IV. Provider business mailing address

PO BOX 58866
WEBSTER TX
77598-8866
US

V. Phone/Fax

Practice location:
  • Phone: 281-338-4000
  • Fax: 281-324-6155
Mailing address:
  • Phone: 281-338-4000
  • Fax: 281-324-6155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD3244
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: