Provider Demographics
NPI:1790706067
Name:DALLAS GASTROENTEROLOGY ASSOCIATES P A
Entity Type:Organization
Organization Name:DALLAS GASTROENTEROLOGY ASSOCIATES P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:MUHAMMAD
Authorized Official - Last Name:OQAIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-820-7455
Mailing Address - Street 1:PO BOX 118377
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75011-8377
Mailing Address - Country:US
Mailing Address - Phone:972-820-7455
Mailing Address - Fax:972-820-7640
Practice Address - Street 1:4323 N JOSEY LN STE 204
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4619
Practice Address - Country:US
Practice Address - Phone:972-820-7455
Practice Address - Fax:972-820-7640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6196207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0091NEOtherBCBS
TX0091NEOtherBCBS