G & G Prosthetic LTD

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

101255 Issued in TX

Legal business name

G & G PROSTHETIC LTD

Practice address

411O S. Clear Creek Road
Suite 109
Killeen, TX 76549

Phone

(254) 771-5002

NPI assigned

Sep 10, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jesse Clint Goss, L/CPO

Title

Owner

Phone

(254) 771-5002

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• G & G Prosthetic LTD

  • Prosthetic/Orthotic Supplier
  • Temple, TX
  • NPI 1598943854

  1153528062

  Same PAC ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ashley Harris Mullen, C.O., L.O.

  • Orthotist
  • Temple, TX
  • NPI 1962835769
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378771200000",
    "number": "1487089397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6901 RIVER PARK CIR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761168465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411O S. CLEAR CREEK ROAD",
            "address_2": "SUITE 109",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "76549",
            "telephone_number": "254-771-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G & G PROSTHETIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-10",
        "last_updated": "2013-09-10",
        "status": "A",
        "authorized_official_last_name": "GOSS",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "CLINT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-771-5002",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L/CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "101255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jed Stewart Fritz, M.D.
• Ieesha Fuller
• Matthew Ryan Fulton, PHARMD
• Kennedy Rae Funk, RBT
• Fusion Dental at Clear Creek PLLC
• Grace Wanjiru Gachucha
• Jasmine Gaffney
• Jessica Gagne, M.S., CCC/SLP
• Eduardo Galindo, PHARMD., RPH
• Ariel Gallien

• Prosthetic/Orthotic Supplier in Killeen, TX
• Providers in Killeen, TX by specialty
• Prosthetic/Orthotic Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.