Provider Demographics
NPI:1013525880
Name:ADVANCED GASTROENTEROLOGY AND NUTRITION OF TEXAS PLLC
Entity type:Organization
Organization Name:ADVANCED GASTROENTEROLOGY AND NUTRITION OF TEXAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:R
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-622-6621
Mailing Address - Street 1:27211 ASHFORD SKY LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3715
Mailing Address - Country:US
Mailing Address - Phone:214-506-1136
Mailing Address - Fax:214-705-3786
Practice Address - Street 1:2255 E MOSSY OAKS RD STE 500
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-1813
Practice Address - Country:US
Practice Address - Phone:214-506-1136
Practice Address - Fax:214-705-3786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty