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NPI Code Detail

MEDICARE: TANYA R. GRUN, M.D., P.A.

MEDICARE: TANYA R. GRUN, M.D., 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
1207Q00000XFamily Medicine PhysicianH8093TX

General Provider Information

NPI Number : 1922240563
Entity Type Code : Organization
Provider Name (Legal Business Name) : TANYA R. GRUN, M.D., P.A.
Provider Business Mailing Address
First Line : 301 MAIN PLZ # 330
Second Line :
City : NEW BRAUNFELS
State : TX
Zip : 78130-5136
Country : US
Telephone Number : 830-279-7690
Fax Number : 830-625-0353
Provider Business Practice Location Address
First Line : 652 N HOUSTON AVE STE 2
Second Line :
City : NEW BRAUNFELS
State : TX
Zip : 78130-4123
Country : US
Telephone Number : 830-279-7690
Fax Number : 830-625-0353
Authorized Official
Title or Position : OWNER/PHYSICIAN
Name : TANYA R. GRUN
Credential : M.D.
Telephone Number : 830-279-7690
Provider Enumeration Date : 03/27/2009
Last Update Date : 06/24/2020

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