Provider Demographics
NPI:1073968392
Name:GMC MEDICAL, PLLC
Entity Type:Organization
Organization Name:GMC MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAIMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RINDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-756-6999
Mailing Address - Street 1:950 E STATE HIGHWAY 114 STE 160
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-5261
Mailing Address - Country:US
Mailing Address - Phone:817-756-6999
Mailing Address - Fax:
Practice Address - Street 1:950 E STATE HIGHWAY 114 STE 160
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-5261
Practice Address - Country:US
Practice Address - Phone:817-756-6999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty