MEDICARE: GR SURGERY,LLC

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	246ZC0007X	Surgical Assistant

General Provider Information

NPI Number	:	1497190938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GR SURGERY,LLC

Provider Business Mailing Address
First Line	:	PO BOX 6565
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77325-6565
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 KINGWOOD DR APT 1721
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-3724
Country	:	US
Telephone Number	:	281-979-5273
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	GREGORY ALAN ROBINSON
Credential	:
Telephone Number	:	281-979-5273

Provider Enumeration Date	:	05/09/2013
Last Update Date	:	05/09/2013

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Directions to “GR SURGERY,LLC ” Practice Location

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