Provider Demographics
NPI:1629450747
Name:GREATER HOUSTON GASTROENTEROLOGY PLLC
Entity Type:Organization
Organization Name:GREATER HOUSTON GASTROENTEROLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:STANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-255-5681
Mailing Address - Street 1:4100 S SHEPHERD DR
Mailing Address - Street 2:SUITE 213
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-5316
Mailing Address - Country:US
Mailing Address - Phone:832-255-5681
Mailing Address - Fax:
Practice Address - Street 1:4100 S SHEPHERD DR
Practice Address - Street 2:SUITE 213
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-5316
Practice Address - Country:US
Practice Address - Phone:832-255-5681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty