Provider Demographics
NPI:1609982867
Name:GRIERT, JEFFERY M (DPM)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:M
Last Name:GRIERT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10970 SHADOW CREEK PKWY
Mailing Address - Street 2:STE 260
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0100
Mailing Address - Country:US
Mailing Address - Phone:713-436-2009
Mailing Address - Fax:713-436-2491
Practice Address - Street 1:10970 SHADOW CREEK PKWY
Practice Address - Street 2:STE 260
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-0100
Practice Address - Country:US
Practice Address - Phone:713-436-2009
Practice Address - Fax:713-436-2491
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1572213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609983Medicare PIN
TX613689Medicare PIN
TXU86346Medicare UPIN
TX6070260001Medicare NSC
TX8517K3Medicare PIN