| Mg Family Medicine, Pllc | |
|
1611 Headway Cir Bldg 2 Austin TX 78754-5165 | |
| (512) 454-3795 | |
| Not Available |
| Full Name | Mg Family Medicine, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1611 Headway Cir Bldg 2, Austin, Texas |
| Authorized Official Name and Position | Minying Gu (SOLE MEMBER) |
| Authorized Official Contact | 6186989314 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mg Family Medicine, Pllc 205 Kettleman Ln N Austin TX 78717-2979 Ph: () - | Mg Family Medicine, Pllc 1611 Headway Cir Bldg 2 Austin TX 78754-5165 Ph: (512) 454-3795 |
| NPI Number | 1164997763 |
|---|---|
| Provider Enumeration Date | 10/10/2018 |
| Last Update Date | 01/30/2021 |
| Medicare PECOS PAC ID | 8022352921 |
|---|---|
| Medicare Enrollment ID | O20181204001394 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164997763 | NPI | - | NPPES |
| 3868218-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Minying Gu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912387556 PECOS PAC ID: 6305156845 Enrollment ID: I20180626002727 |
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