Grimes, Kelly Damon
Grimes, Kelly Damon is an sole proprietor health care provider with primary practice located at 3437 W 7Th St Suite 210, Fort Worth TX 76107-2718. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine. Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine is his primary health care specialty. Grimes, Kelly Damon can be contacted via phone (817) 797-6599.Contact Information
Primary practice address
3437 W 7Th St Suite 210
Fort Worth TX 76107-2718
Phone: (817) 797-6599
Fax: (817) 735-8049
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | K7749 | Texas |
| Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine | 2083P0011X | K7749 | Texas |
Profile Details
| NPI number | 1497787873 |
|---|---|
| LBN Legal business name | Grimes, Kelly Damon |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 7th, 2006 |
| Last updated | Jan 25th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497787873 | NPPES |
| Texas | MEDICAID | 144815104 | |
| Texas | Other | 0056PJ |
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