Provider Demographics
NPI:1891125621
Name:GASTROTEXAS SURGERY LLC
Entity Type:Organization
Organization Name:GASTROTEXAS SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CENTER MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRONAWITTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-330-3381
Mailing Address - Street 1:777 E ATLANTIC AVENUE, C/O HDA ENTERPRISES, INC.
Mailing Address - Street 2:SUITE 222
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24730 KINGSLAND BLVD.
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494
Practice Address - Country:US
Practice Address - Phone:561-330-3381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical