| Kingwood Gastroenterology Pllc | |
|
210 W Park Ste 100 Livingston TX 77351-8337 | |
| (281) 501-5652 | |
| Not Available |
| Full Name | Kingwood Gastroenterology Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 210 W Park Ste 100, Livingston, Texas |
| Authorized Official Name and Position | Georg Elias (MANAGER) |
| Authorized Official Contact | 6185595196 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingwood Gastroenterology Pllc Po Box 87 Porter TX 77365-0087 Ph: (618) 559-5196 | Kingwood Gastroenterology Pllc 210 W Park Ste 100 Livingston TX 77351-8337 Ph: (281) 501-5652 |
| NPI Number | 1033716014 |
|---|---|
| Provider Enumeration Date | 10/03/2020 |
| Last Update Date | 12/21/2020 |
| Medicare PECOS PAC ID | 5496166340 |
|---|---|
| Medicare Enrollment ID | O20201124002830 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033716014 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Georg Elias |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1952542680 PECOS PAC ID: 6608016860 Enrollment ID: I20160826000697 |
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