Provider Demographics
NPI:1104027754
Name:GASTROINTESTINAL & LIVER DISEASE CENTER PLLC
Entity Type:Organization
Organization Name:GASTROINTESTINAL & LIVER DISEASE CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:IVAN
Authorized Official - Last Name:RODRIGUEZ-LUNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-734-8737
Mailing Address - Street 1:9305 W THOMAS RD
Mailing Address - Street 2:SUITE #225
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-3328
Mailing Address - Country:US
Mailing Address - Phone:623-236-8507
Mailing Address - Fax:
Practice Address - Street 1:9305 W THOMAS RD
Practice Address - Street 2:SUITE #255
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3328
Practice Address - Country:US
Practice Address - Phone:480-734-8737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty