Provider Demographics
NPI:1447562863
Name:GB MEDICAL GROUP PLLC
Entity Type:Organization
Organization Name:GB MEDICAL GROUP PLLC
Other - Org Name:FIRST MED MIDLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:432-618-5215
Mailing Address - Street 1:3401 GREENBRIAR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-4607
Mailing Address - Country:US
Mailing Address - Phone:432-618-5215
Mailing Address - Fax:432-618-5253
Practice Address - Street 1:3401 GREENBRIAR
Practice Address - Street 2:SUITE 200
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-4607
Practice Address - Country:US
Practice Address - Phone:432-618-5215
Practice Address - Fax:432-618-5253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-14
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9786207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH9786OtherMEDICAL LICENSE