Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | J2039 | TX |
Y | 207RI0011X | Interventional Cardiology | J2039 | TX |
NPI | 1073539755 |
---|---|
Provider Name | Dr. Gustavo A Grieco |
First Address | Houston, TX 77090-1246 |
Second Address | Houston, TX 77090-1246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 01/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F76614 | (02) | TX |