Provider Demographics
NPI:1740754944
Name:GASTRO1 RECEIVABLES PURCHASING, LLC
Entity Type:Organization
Organization Name:GASTRO1 RECEIVABLES PURCHASING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:RUKAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DACCAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-910-7779
Mailing Address - Street 1:4450 E SAM HOUSTON PKWY S STE H2
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3950
Mailing Address - Country:US
Mailing Address - Phone:713-910-7779
Mailing Address - Fax:713-910-7760
Practice Address - Street 1:3534 VISTA RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1728
Practice Address - Country:US
Practice Address - Phone:713-947-0330
Practice Address - Fax:713-947-6562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty