| Athens Gastroenterology Pa | |
|
901 S Palestine Athens TX 75751 | |
| (903) 677-3737 | |
| (903) 677-6014 |
| Full Name | Athens Gastroenterology Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 901 S Palestine, Athens, Texas |
| Authorized Official Name and Position | Jay A Takata (PRESIDENT CEO) |
| Authorized Official Contact | 9036773737 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Athens Gastroenterology Pa 901 S Palestine Athens TX 75751 Ph: (903) 677-3737 | Athens Gastroenterology Pa 901 S Palestine Athens TX 75751 Ph: (903) 677-3737 |
| NPI Number | 1568473916 |
|---|---|
| Provider Enumeration Date | 08/11/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4880588201 |
|---|---|
| Medicare Enrollment ID | O20040209000392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568473916 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | K7400 (Texas) | Primary |
| Provider Name | Jay A Takata |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1083801518 PECOS PAC ID: 6507750924 Enrollment ID: I20040209000420 |
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