MEDICARE: LOVE H GRIMES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1568593614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOVE H GRIMES

Provider Business Mailing Address
First Line	:	9100 MILLS RD
Second Line	:	1504
City	:	HOUSTON
State	:	TX
Zip	:	77070-5548
Country	:	US
Telephone Number	:	281-898-4311
Fax Number	:

Provider Business Practice Location Address
First Line	:	5850 SAN FELIPE ST
Second Line	:	500
City	:	HOUSTON
State	:	TX
Zip	:	77057-3070
Country	:	US
Telephone Number	:	713-706-6180
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	07/08/2007

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Directions to “ LOVE H GRIMES ” Practice Location

Language	Start Address	Practice Location

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