Individual
FRED E GRUNDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
RR 8 BOX 665, JASPER, TX 75951-9498
(409) 384-6544
Mailing address
RR 8 BOX 665, JASPER, TX 75951-9498
(409) 384-6544
(409) 384-9359
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
234517
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
032172
RECERTIFICATION CRNA
TX
Enumeration date
10/21/2005
Last updated
08/10/2007
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