| Nacogdoches Gastroenterology Pllc | |
|
522 Russell Blvd Nacogdoches TX 75965-1244 | |
| (936) 569-2000 | |
| (936) 569-2002 |
| Full Name | Nacogdoches Gastroenterology Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 522 Russell Blvd, Nacogdoches, Texas |
| Authorized Official Name and Position | Carl Jones (GASTROENTEROLOGIST) |
| Authorized Official Contact | 9365692000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nacogdoches Gastroenterology Pllc 522 Russell Blvd Nacogdoches TX 75965-1244 Ph: (936) 569-2000 | Nacogdoches Gastroenterology Pllc 522 Russell Blvd Nacogdoches TX 75965-1244 Ph: (936) 569-2000 |
| NPI Number | 1841881794 |
|---|---|
| Provider Enumeration Date | 02/02/2021 |
| Last Update Date | 08/11/2021 |
| Medicare PECOS PAC ID | 4183021777 |
|---|---|
| Medicare Enrollment ID | O20210924000027 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841881794 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Carl R Jones |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760478838 PECOS PAC ID: 5991748063 Enrollment ID: I20120824000750 |
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