Provider Demographics
NPI:1811238454
Name:HOUSTON GASTRO INSTITUTE PLLC
Entity Type:Organization
Organization Name:HOUSTON GASTRO INSTITUTE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ASAMOAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-940-0561
Mailing Address - Street 1:25230 KINGSLAND BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2097
Mailing Address - Country:US
Mailing Address - Phone:281-746-9284
Mailing Address - Fax:877-327-8082
Practice Address - Street 1:25230 KINGSLAND BLVD STE 101
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2097
Practice Address - Country:US
Practice Address - Phone:281-746-9284
Practice Address - Fax:877-327-8082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0163207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP0163OtherLICENSE
TX337250Medicare PIN
TX285404401Medicaid