Provider Demographics
NPI:1730664657
Name:GCR INTEGRATED HEALTH PLLC
Entity Type:Organization
Organization Name:GCR INTEGRATED HEALTH PLLC
Other - Org Name:ADVANCED INTEGRATED MEDICAL CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-310-6604
Mailing Address - Street 1:100 W SOUTHLAKE BLVD STE 410
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6166
Mailing Address - Country:US
Mailing Address - Phone:817-310-6604
Mailing Address - Fax:
Practice Address - Street 1:100 W SOUTHLAKE BLVD STE 410
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6166
Practice Address - Country:US
Practice Address - Phone:817-310-6604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-26
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty