Provider Demographics
NPI:1053173005
Name:GMG CLINICAL RESEARCH, LLC
Entity type:Organization
Organization Name:GMG CLINICAL RESEARCH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VANNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:512-556-4130
Mailing Address - Street 1:207 W AVENUE E
Mailing Address - Street 2:
Mailing Address - City:LAMPASAS
Mailing Address - State:TX
Mailing Address - Zip Code:76550-1820
Mailing Address - Country:US
Mailing Address - Phone:512-556-4130
Mailing Address - Fax:512-556-4130
Practice Address - Street 1:207 W AVENUE E
Practice Address - Street 2:
Practice Address - City:LAMPASAS
Practice Address - State:TX
Practice Address - Zip Code:76550-1820
Practice Address - Country:US
Practice Address - Phone:512-556-4130
Practice Address - Fax:512-556-4130
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GMG CLINICAL RESEARCH, LLD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch