Gastromedconnect, Pllc | |
115 Kohlers Crossing Ste 455 Kyle TX 78640-2464 | |
(512) 454-5911 | |
Not Available |
Full Name | Gastromedconnect, Pllc |
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Speciality | Internal Medicine |
Location | 115 Kohlers Crossing Ste 455, Kyle, Texas |
Authorized Official Name and Position | Sami Adib (MD/OWNER) |
Authorized Official Contact | 5124545911 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Gastromedconnect, Pllc 115 Kohlers Crossing Ste 455 Kyle TX 78640 Ph: () - | Gastromedconnect, Pllc 115 Kohlers Crossing Ste 455 Kyle TX 78640-2464 Ph: (512) 454-5911 |
NPI Number | 1639852189 |
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Provider Enumeration Date | 08/10/2023 |
Last Update Date | 08/25/2023 |
Medicare PECOS PAC ID | 7214391127 |
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Medicare Enrollment ID | O20230911004072 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639852189 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
Provider Name | Sami N Adib |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1548502412 PECOS PAC ID: 1456755743 Enrollment ID: I20210809002706 |
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