Provider Demographics
NPI:1053364786
Name:GRUVER, DANIEL MARCUS (OD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MARCUS
Last Name:GRUVER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2830 SUMMIT RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-4950
Mailing Address - Country:US
Mailing Address - Phone:762-208-8002
Mailing Address - Fax:
Practice Address - Street 1:CMR 454
Practice Address - Street 2:KATTERBACH HEALTH CLINIC
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09177
Practice Address - Country:DE
Practice Address - Phone:01149980-283-2168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4977TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist