Provider Demographics
NPI:1063239770
Name:MCGRIGGLER, BETTINA
Entity type:Individual
Prefix:
First Name:BETTINA
Middle Name:
Last Name:MCGRIGGLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8940 FOURWINDS DR STE 305
Mailing Address - Street 2:
Mailing Address - City:WINDCREST
Mailing Address - State:TX
Mailing Address - Zip Code:78239-1900
Mailing Address - Country:US
Mailing Address - Phone:210-267-1252
Mailing Address - Fax:210-625-5598
Practice Address - Street 1:8940 FOURWINDS DR STE 305
Practice Address - Street 2:
Practice Address - City:WINDCREST
Practice Address - State:TX
Practice Address - Zip Code:78239-1900
Practice Address - Country:US
Practice Address - Phone:210-267-1252
Practice Address - Fax:210-625-5598
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1952748964OtherNPI
TX1053174144OtherNPI
TX1326827726OtherNPI