Provider Demographics
NPI:1629836697
Name:HOUSTON PEDIATRIC GASTROENTEROLOGY, PLLC
Entity type:Organization
Organization Name:HOUSTON PEDIATRIC GASTROENTEROLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHISH
Authorized Official - Middle Name:NARAYAN
Authorized Official - Last Name:DEBROY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-285-2938
Mailing Address - Street 1:2700 CULLEN BLVD UNIT 842247
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1989
Mailing Address - Country:US
Mailing Address - Phone:832-285-2938
Mailing Address - Fax:
Practice Address - Street 1:2045 SPACE PARK DR STE 280
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-6311
Practice Address - Country:US
Practice Address - Phone:832-205-8215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-13
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Single Specialty