Basic Information
| Provider Information | |||||||||
| NPI: | 1932312865 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | J.G HEALTH CARE, INC. | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | J.G. HEALTHCARE, INC. | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 6201 BONHOMME RD STE 330N | ||||||||
| Address2: | 6201 BONHOMME RD STE 330-N | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770364423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7139721134 | ||||||||
| FaxNumber: | 7137841725 | ||||||||
| Practice Location | |||||||||
| Address1: | 6201 BONHOMME RD STE 330N | ||||||||
| Address2: | 6201 BONHOMME STE 330-N | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770364423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7139721134 | ||||||||
| FaxNumber: | 7137841725 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | GRANADOS | ||||||||
| AuthorizedOfficialFirstName: | MARIA | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7139721134 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | 0093046 | TX | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.