Gulf Coast Gastroenterology, Pa | |
219 Oak Dr S Ste A Lake Jackson TX 77566-5675 | |
(979) 297-4033 | |
(979) 297-4099 |
Full Name | Gulf Coast Gastroenterology, Pa |
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Speciality | Internal Medicine |
Location | 219 Oak Dr S Ste A, Lake Jackson, Texas |
Authorized Official Name and Position | Britiany Bush (OFFICE MANAGER) |
Authorized Official Contact | 9792974033 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Gulf Coast Gastroenterology, Pa 104 Circle Way St Ste B Lake Jackson TX 77566-5200 Ph: (979) 297-4033 | Gulf Coast Gastroenterology, Pa 219 Oak Dr S Ste A Lake Jackson TX 77566-5675 Ph: (979) 297-4033 |
NPI Number | 1104904077 |
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Provider Enumeration Date | 11/01/2006 |
Last Update Date | 09/18/2023 |
Medicare PECOS PAC ID | 6608882857 |
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Medicare Enrollment ID | O20060227000202 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104904077 | NPI | - | NPPES |
181777701 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
Provider Name | William H Sweatt |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1255330445 PECOS PAC ID: 8325015654 Enrollment ID: I20060227000209 |
Provider Name | Jami Damron |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982366209 PECOS PAC ID: 1254727522 Enrollment ID: I20220413002649 |
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