Provider Demographics
NPI:1407993140
Name:GUARDIAN ANGEL MEDICAL SUPPLY INC.
Entity type:Organization
Organization Name:GUARDIAN ANGEL MEDICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARNULFO
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-572-3455
Mailing Address - Street 1:1720 REGAL ROW
Mailing Address - Street 2:STE.226
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-2299
Mailing Address - Country:US
Mailing Address - Phone:972-572-3455
Mailing Address - Fax:972-709-2519
Practice Address - Street 1:1720 REGAL ROW
Practice Address - Street 2:STE.226
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-2299
Practice Address - Country:US
Practice Address - Phone:972-572-3455
Practice Address - Fax:972-709-2519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty