| Texas Digestive Disease Consultants, Pllc | |
|
505 S Nolen Dr Ste A Southlake TX 76092-9167 | |
| (817) 424-1525 | |
| (817) 424-3491 |
| Full Name | Texas Digestive Disease Consultants, Pllc |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 505 S Nolen Dr, Southlake, Texas |
| Authorized Official Name and Position | Stephanie Summerall (SVP, PAYER RELATIONS) |
| Authorized Official Contact | 2144242200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Texas Digestive Disease Consultants, Pllc Po Box 35629 Dallas TX 75235-0629 Ph: (214) 424-2200 | Texas Digestive Disease Consultants, Pllc 505 S Nolen Dr Ste A Southlake TX 76092-9167 Ph: (817) 424-1525 |
| NPI Number | 1649256546 |
|---|---|
| Provider Enumeration Date | 12/22/2005 |
| Last Update Date | 06/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649256546 | NPI | - | NPPES |
| 081585402 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
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