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General NPI Number Information
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NPI Number | 1720643992
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Entity Type | Organization
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Legal Business Name | MG MEDICAL BILLING LLC
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Dates
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Enumeration Date | 05/03/2019
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Last Update Date | 07/22/2022
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Provider Practice Location Address
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Address Line | 16874 FM 463
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City | LYTLE
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State | TX
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Zip | 78052-4515
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Country | US
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Telephone | 210-239-6873
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Fax |
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Provider Business Mailing Address
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Address Line | 16874 FM 463
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City | LYTLE
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State | TX
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Zip | 78052-4515
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Country | US
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Telephone | 210-239-6873
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Fax |
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | MR. MARK JOSEPH GONZALES
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Credential | CST,SA-C,CSFA
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Telephone | 210-316-3646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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