Provider Demographics
NPI:1043337074
Name:SOUTHWEST GASTOENTEROLOGY PA
Entity Type:Organization
Organization Name:SOUTHWEST GASTOENTEROLOGY PA
Other - Org Name:TONY N TSEN MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:N
Authorized Official - Last Name:TSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-372-9042
Mailing Address - Street 1:PO BOX 2256
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78156-2256
Mailing Address - Country:US
Mailing Address - Phone:830-372-9042
Mailing Address - Fax:830-382-2391
Practice Address - Street 1:911 S STATE HWY 123 BYPASS
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-9754
Practice Address - Country:US
Practice Address - Phone:830-372-9042
Practice Address - Fax:830-372-2391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8152207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF58934OtherUPIN
TX131242306Medicaid
TXJ8152OtherTEXAS MEDICAL LICENSE #
TXV0091792OtherDPS
TXV0091792OtherDPS
TXJ8152OtherTEXAS MEDICAL LICENSE #