Provider Demographics
NPI:1174358691
Name:GRUENE TREE HEALTH, PLLC
Entity type:Organization
Organization Name:GRUENE TREE HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:DANE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUENEBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:361-660-8405
Mailing Address - Street 1:4702 TIARA LN
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78415-2174
Mailing Address - Country:US
Mailing Address - Phone:361-660-8405
Mailing Address - Fax:
Practice Address - Street 1:6202 YORKTOWN BLVD STE 106
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-5865
Practice Address - Country:US
Practice Address - Phone:361-660-8405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty