MEDICARE: DR. GEORGE M GRUNERT M.D.

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	207VE0102X	Reproductive Endocrinology Physician	E0945	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	83047G	OTHER	TX	BLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number	:	1396748349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE M GRUNERT M.D.

Provider Business Mailing Address
First Line	:	PO BOX 631607
Second Line	:	HOUSTON FERTILITY SPECIALISTS PLLC
City	:	CINCINNATI
State	:	OH
Zip	:	45263-1607
Country	:	US
Telephone Number	:	713-300-1123
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 FONDREN RD STE 300
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-2313
Country	:	US
Telephone Number	:	713-730-2229
Fax Number	:	713-334-5547

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	03/10/2025

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