Provider Demographics
NPI:1073968392
Name:GMC MEDICAL, PLLC
Entity type:Organization
Organization Name:GMC MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAEID
Authorized Official - Middle Name:ESMAEILY
Authorized Official - Last Name:ARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-304-0024
Mailing Address - Street 1:2600 E SOUTHLAKE BLVD STE 120-147
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6634
Mailing Address - Country:US
Mailing Address - Phone:214-304-0024
Mailing Address - Fax:
Practice Address - Street 1:2600 E SOUTHLAKE BLVD STE 120-147
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6634
Practice Address - Country:US
Practice Address - Phone:214-304-0024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty