| Longview Gastroenterology Clinic | |
|
905 Pegues Pl Longview TX 75601-4027 | |
| (903) 753-6688 | |
| (903) 238-9161 |
| Full Name | Longview Gastroenterology Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 905 Pegues Pl, Longview, Texas |
| Authorized Official Name and Position | Johnasan M Gregory (PHYSICIAN) |
| Authorized Official Contact | 9037536688 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Longview Gastroenterology Clinic 905 Pegues Pl Longview TX 75601-4027 Ph: (903) 753-6688 | Longview Gastroenterology Clinic 905 Pegues Pl Longview TX 75601-4027 Ph: (903) 753-6688 |
| NPI Number | 1174939292 |
|---|---|
| Provider Enumeration Date | 07/09/2014 |
| Last Update Date | 07/10/2014 |
| Medicare PECOS PAC ID | 2769706860 |
|---|---|
| Medicare Enrollment ID | O20150120002228 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174939292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | G8150 (Texas) | Primary |
| Provider Name | Johnasan M Gregory |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1699774869 PECOS PAC ID: 5698742922 Enrollment ID: I20060202000660 |
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