Provider Demographics
NPI:1578346482
Name:GX2 VENTURES LLC
Entity Type:Organization
Organization Name:GX2 VENTURES LLC
Other - Org Name:FYZICAL THERAPY & BALANCE CENTERS-BALCONES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, OPERATING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK-ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMBOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-642-5599
Mailing Address - Street 1:6703 BLACKSMITH LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-2123
Mailing Address - Country:US
Mailing Address - Phone:210-365-2866
Mailing Address - Fax:
Practice Address - Street 1:5770 N MOPAC EXPY STE 150
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4236
Practice Address - Country:US
Practice Address - Phone:512-642-5599
Practice Address - Fax:210-971-6384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-15
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy