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General NPI Number Information
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NPI Number | 1134205768
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Entity Type | Organization
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Legal Business Name | GMN ASSOCIATES
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 08/26/2009
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Provider Practice Location Address
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Address Line | 403 W CAMPBELL RD # 205
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City | RICHARDSON
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State | TX
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Zip | 75080-3465
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Country | US
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Telephone | 972-498-4000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 740968
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City | DALLAS
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State | TX
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Zip | 75374-0968
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Country | US
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Telephone | 800-945-2455
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Fax | 903-453-2541
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS G JOHNSON
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Credential | MD
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Telephone | 972-498-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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