Provider Demographics
NPI:1063411775
Name:GRIPON, EDWARD BROWN (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:BROWN
Last Name:GRIPON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3560 DELAWARE ST
Mailing Address - Street 2:#502
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-3067
Mailing Address - Country:US
Mailing Address - Phone:409-899-4472
Mailing Address - Fax:
Practice Address - Street 1:3560 DELAWARE ST
Practice Address - Street 2:#502
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-3067
Practice Address - Country:US
Practice Address - Phone:409-899-4472
Practice Address - Fax:409-899-9795
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-15
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXD50202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry