Provider Demographics
NPI:1417111626
Name:RAINBOW MEDICAL PLLC
Entity Type:Organization
Organization Name:RAINBOW MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GORDANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GLIGORIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-807-3889
Mailing Address - Street 1:PO BOX 1182
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-1182
Mailing Address - Country:US
Mailing Address - Phone:210-807-3889
Mailing Address - Fax:
Practice Address - Street 1:4242 MEDICAL DR
Practice Address - Street 2:SUITE 6100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5640
Practice Address - Country:US
Practice Address - Phone:210-807-3889
Practice Address - Fax:210-888-5851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3660174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty