Provider Demographics
NPI:1922669647
Name:GL HEALTHCARE OF EAST TEXAS LLC
Entity Type:Organization
Organization Name:GL HEALTHCARE OF EAST TEXAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-412-1585
Mailing Address - Street 1:1731 S BECKHAM AVE
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-4436
Mailing Address - Country:US
Mailing Address - Phone:904-412-1585
Mailing Address - Fax:
Practice Address - Street 1:1731 S BECKHAM AVE
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-4436
Practice Address - Country:US
Practice Address - Phone:904-412-1585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care