Provider Demographics
NPI:1750610135
Name:J.G. GROUP L.L.C.
Entity type:Organization
Organization Name:J.G. GROUP L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:ASCENCION
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:806-548-7247
Mailing Address - Street 1:6507 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-3763
Mailing Address - Country:US
Mailing Address - Phone:806-548-7247
Mailing Address - Fax:806-771-9333
Practice Address - Street 1:8207 HUDSON AVE STE D
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2805
Practice Address - Country:US
Practice Address - Phone:806-548-7247
Practice Address - Fax:806-771-9333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11021111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty