Provider Demographics
NPI:1003940586
Name:DIGESTIVE ASSOCIATES OF HOUSTON, PA
Entity Type:Organization
Organization Name:DIGESTIVE ASSOCIATES OF HOUSTON, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:RAIJMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-795-4444
Mailing Address - Street 1:4100 S SHEPHERD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-5316
Mailing Address - Country:US
Mailing Address - Phone:713-795-4444
Mailing Address - Fax:713-795-5254
Practice Address - Street 1:4100 S SHEPHERD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-5316
Practice Address - Country:US
Practice Address - Phone:713-795-4444
Practice Address - Fax:713-795-5254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7210207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148009701Medicaid
TX0076HGOtherBCBS GROUP #
TX00998RMedicare PIN