Provider Demographics
NPI:1821127002
Name:GASTROENTEROLOGY CONSULTANTS OF SOUTH TEXAS, PLLC
Entity Type:Organization
Organization Name:GASTROENTEROLOGY CONSULTANTS OF SOUTH TEXAS, PLLC
Other - Org Name:TEXAS DIGESTIVE SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NOLAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-365-4400
Mailing Address - Street 1:512 VICTORIA LN
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-3226
Mailing Address - Country:US
Mailing Address - Phone:956-365-4400
Mailing Address - Fax:
Practice Address - Street 1:512 VICTORIA LN STE 2
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-3227
Practice Address - Country:US
Practice Address - Phone:956-365-4400
Practice Address - Fax:956-365-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX186270802Medicaid