Provider Demographics
NPI:1942406889
Name:HOUSTON GASTROENTEROLOGY ASSOCIATES
Entity Type:Organization
Organization Name:HOUSTON GASTROENTEROLOGY ASSOCIATES
Other - Org Name:CRAIG S. GORDON, M.D.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:CY
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-647-6667
Mailing Address - Street 1:21316 PROVINCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-7580
Mailing Address - Country:US
Mailing Address - Phone:281-647-6667
Mailing Address - Fax:281-647-6610
Practice Address - Street 1:21316 PROVINCIAL BLVD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-7580
Practice Address - Country:US
Practice Address - Phone:281-647-6667
Practice Address - Fax:281-647-6610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00K29JMedicare PIN