0001694306-21-000001.txt : 20210503 0001694306-21-000001.hdr.sgml : 20210503 20210503091433 ACCESSION NUMBER: 0001694306-21-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20210503 DATE AS OF CHANGE: 20210503 EFFECTIVENESS DATE: 20210503 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ColubrisMX, Inc. CENTRAL INDEX KEY: 0001694306 IRS NUMBER: 811763899 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-397911 FILM NUMBER: 21881660 BUSINESS ADDRESS: STREET 1: 327 TERRACE DRIVE CITY: HOUSTON STATE: TX ZIP: 77007 BUSINESS PHONE: 832-472-5156 MAIL ADDRESS: STREET 1: 327 TERRACE DRIVE CITY: HOUSTON STATE: TX ZIP: 77007 D 1 primary_doc.xml X0708 D LIVE 0001694306 ColubrisMX, Inc. 9310 Kirby Drive Suite 100 HOUSTON TX TEXAS 77054 650-714-1479 DELAWARE None None Corporation true Daniel Kim, MD 9310 Kirby Drive Suite 100 Houston TX TEXAS 77054 Executive Officer Director Neeraj Agrawal 9310 Kirby Drive Suite 100 Houston TX TEXAS 77054 Director R. Cary McNair, Jr. 9310 Kirby Drive Suite 100 Houston TX TEXAS 77054 Director Eduardo Ramon Alejandro Fonseca Ward 9310 Kirby Drive Suite 100 Houston TX TEXAS 77054 Director Kurt Azarbarzin 9310 Kirby Drive Suite 100 Houston TX TEXAS 77054 Executive Officer Director Other Health Care Decline to Disclose 06b false 2021-04-16 false true false 0 GT Securities, Inc. 116012 None None 12130 Millennium Drive Suite 300 Los Angeles CA CALIFORNIA 90094 CA CALIFORNIA MD MARYLAND TX TEXAS WA WASHINGTON true 76076973 68993973 7083000 false 7 3200000 true 0 0 false ColubrisMX, Inc. Kurt Azarbarzin Kurt Azarbarzin Chief Executive Officer 2021-05-03