Provider Demographics
NPI:1770959934
Name:GG MEDICAL INC
Entity type:Organization
Organization Name:GG MEDICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GUAJARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-495-0753
Mailing Address - Street 1:614 W FRENCH PL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-3634
Mailing Address - Country:US
Mailing Address - Phone:210-225-0607
Mailing Address - Fax:210-226-8460
Practice Address - Street 1:614 W FRENCH PL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-3634
Practice Address - Country:US
Practice Address - Phone:210-225-0607
Practice Address - Fax:210-226-8460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX250023336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2153411OtherPK