Provider Demographics
NPI:1568657567
Name:NORTH TEXAS GASTROENTEROLOGY CONSULTANTS PA
Entity Type:Organization
Organization Name:NORTH TEXAS GASTROENTEROLOGY CONSULTANTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMJAD
Authorized Official - Middle Name:NAEEM
Authorized Official - Last Name:AWAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-898-7488
Mailing Address - Street 1:106 N DENTON TAP RD # 210-352
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2138
Mailing Address - Country:US
Mailing Address - Phone:940-898-7488
Mailing Address - Fax:940-243-3554
Practice Address - Street 1:3304 COLORADO BLVD STE 205
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6877
Practice Address - Country:US
Practice Address - Phone:940-898-7488
Practice Address - Fax:940-243-3554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9017207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141655403Medicaid
TX8G0100OtherBC/BS
TX219119901Medicaid
TX141655402Medicaid
TX141655404Medicaid
TX141655405Medicaid
TX1073578753OtherPERSONAL NPI
TXDH1825OtherRAIL ROAD MEDICARE
TX00Y801Medicare PIN
TX1073578753OtherPERSONAL NPI
TX00Y801Medicare PIN