| Digestive Disease Consultants Pa | |
|
9816 Memorial Blvd #206 Humble TX 77338 | |
| (281) 446-8114 | |
| (281) 446-1158 |
| Full Name | Digestive Disease Consultants Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 9816 Memorial Blvd, Humble, Texas |
| Authorized Official Name and Position | Starr Lee Wallace (LVN OFFICE MANAGER) |
| Authorized Official Contact | 2814468114 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Digestive Disease Consultants Pa 9816 Memorial Blvd #206 Humble TX 77338 Ph: (281) 446-8114 | Digestive Disease Consultants Pa 9816 Memorial Blvd #206 Humble TX 77338 Ph: (281) 446-8114 |
| NPI Number | 1376629964 |
|---|---|
| Provider Enumeration Date | 10/27/2006 |
| Last Update Date | 07/09/2008 |
| Medicare PECOS PAC ID | 5890754402 |
|---|---|
| Medicare Enrollment ID | O20041008000554 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376629964 | NPI | - | NPPES |
| 081671201 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Srinivasan R Nathan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1235326828 PECOS PAC ID: 3870552482 Enrollment ID: I20111116000080 |
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