Individual provider Active NPI

Edward M Gronet, MD

  • Plastic Surgery Physician
  • Temple, TX
National Provider Identifier
1457741753
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
BP10047436 Issued in TX
Practice address
2401 S 31St St
Temple, TX 76508-0001
Phone
(254) 724-0630
NPI assigned
Jan 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X BP10047436 TX Primary

Addresses

Primary practice location

2401 S 31St St
Temple, TX 76508-0001

Mailing address

2401 S 31St St
Temple, TX 76508-0001
Phone (254) 724-0630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160113001965 TX Practitioner - Plastic and Reconstructive SurgeryPractitioner - Emergency Medicine 0143522789 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10047436TXMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Aesthetic and Reconstructive Surgery PLLC CurrentSince Jul 1, 2019 Accepting new patients
Concord Medical Group PLLC CurrentSince Nov 27, 2015 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Nov 27, 2015 Accepting new patients

Locations

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

8042 Wurzbach Rd
Ste 130
San Antonio, TX 78229
Phone (210) 201-2806

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1457741753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "254-724-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "254-724-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONET",
        "first_name": "EDWARD",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-26",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "BP10047436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.