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General NPI Number Information
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NPI Number | 1053173005
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Entity Type | Organization
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Legal Business Name | GMG CLINICAL RESEARCH, LLC
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Dates
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Enumeration Date | 01/25/2024
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 207 W AVENUE E
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City | LAMPASAS
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State | TX
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Zip | 76550-1820
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Country | US
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Telephone | 512-556-4130
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Fax | 512-556-4130
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Provider Business Mailing Address
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Address Line | 207 W AVENUE E
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City | LAMPASAS
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State | TX
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Zip | 76550-1820
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Country | US
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Telephone | 512-556-4130
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Fax | 512-556-4130
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VANNA S GOLD
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Credential | DO
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Telephone | 512-556-4130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number |
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License Number State |
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