MEDICARE: C. GRUESBECK/F.D. CRUZ, MD, P.A.

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	207Q00000X	Family Medicine Physician	H7749	TX

General Provider Information

NPI Number	:	1295782993
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C. GRUESBECK/F.D. CRUZ, MD, P.A.

Provider Business Mailing Address
First Line	:	5245 WALZEM RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78218-2122
Country	:	US
Telephone Number	:	210-654-9700
Fax Number	:

Provider Business Practice Location Address
First Line	:	5245 WALZEM RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78218-2122
Country	:	US
Telephone Number	:	210-654-9700
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CLAY GRUESBECK
Credential	:	M.D.
Telephone Number	:	210-654-9700

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	01/07/2010

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