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NPI Code Detail

MEDICARE: JIG MEDICAL MANAGEMENT GROUP,INC

MEDICARE: JIG MEDICAL MANAGEMENT GROUP,INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianL1955TX

General Provider Information

NPI Number : 1336345024
Entity Type Code : Organization
Provider Name (Legal Business Name) : JIG MEDICAL MANAGEMENT GROUP,INC
Provider Business Mailing Address
First Line : 10807 GOLDEN GRAIN DR
Second Line :
City : HOUSTON
State : TX
Zip : 77064-4407
Country : US
Telephone Number : 281-591-8688
Fax Number :
Provider Business Practice Location Address
First Line : 11012 AIRLINE DR STE A
Second Line :
City : HOUSTON
State : TX
Zip : 77037-1112
Country : US
Telephone Number : 281-591-8688
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. JOSE I GONZALEZ JR.
Credential :
Telephone Number : 281-591-8688
Provider Enumeration Date : 06/21/2007
Last Update Date : 08/22/2020

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Directions to “JIG MEDICAL MANAGEMENT GROUP,INC ” Practice Location

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