Provider Demographics
NPI:1275757296
Name:GASTROINTESTINAL CONSULTANTS OF HOUSTON PA
Entity Type:Organization
Organization Name:GASTROINTESTINAL CONSULTANTS OF HOUSTON PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHICKI
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:MATHIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-795-4843
Mailing Address - Street 1:7501 FANNIN ST
Mailing Address - Street 2:STE 705
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1938
Mailing Address - Country:US
Mailing Address - Phone:713-795-4843
Mailing Address - Fax:713-795-4839
Practice Address - Street 1:7501 FANNIN ST
Practice Address - Street 2:STE 705
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1938
Practice Address - Country:US
Practice Address - Phone:713-795-4843
Practice Address - Fax:713-795-4839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5378207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8X7710OtherBC BS OF TEXAS
0032PLMedicare ID - Type Unspecified