Provider Demographics
NPI:1477652964
Name:PERMIAN GASTROENTEROLOGY, P.A.
Entity Type:Organization
Organization Name:PERMIAN GASTROENTEROLOGY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GOVIND
Authorized Official - Middle Name:BHOGILAL
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:432-697-1000
Mailing Address - Street 1:4214 ANDREWS HWY STE 203
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79703-4871
Mailing Address - Country:US
Mailing Address - Phone:432-697-1000
Mailing Address - Fax:432-697-6000
Practice Address - Street 1:4214 ANDREWS HWY STE 203
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79703-4871
Practice Address - Country:US
Practice Address - Phone:432-697-1000
Practice Address - Fax:432-697-6000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCI6074 GROUP NUMBEROtherRAILROAD MEDICARE
TXCI6074 GROUP NUMBEROtherRAILROAD MEDICARE