Provider Demographics
NPI:1609066448
Name:G&J DOCTORS GROUP
Entity Type:Organization
Organization Name:G&J DOCTORS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-691-9090
Mailing Address - Street 1:4150 SOUTHWEST DR STE 101
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-8292
Mailing Address - Country:US
Mailing Address - Phone:325-691-9090
Mailing Address - Fax:
Practice Address - Street 1:4150 SOUTHWEST DR
Practice Address - Street 2:SUITE 101
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-8222
Practice Address - Country:US
Practice Address - Phone:325-691-9090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX 3392152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty