Provider Demographics
NPI:1083889075
Name:ANG GARA LLC
Entity Type:Organization
Organization Name:ANG GARA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-316-4557
Mailing Address - Street 1:9571 NEW WORLD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239-2332
Mailing Address - Country:US
Mailing Address - Phone:210-381-2074
Mailing Address - Fax:
Practice Address - Street 1:9571 NEW WORLD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78239-2332
Practice Address - Country:US
Practice Address - Phone:210-381-2074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility