Provider Demographics
NPI:1740486810
Name:ATILLA ERTAN MD PA
Entity type:Organization
Organization Name:ATILLA ERTAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GASTROENTEROLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ATILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ERTAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:713-794-0001
Mailing Address - Street 1:DEPT 497
Mailing Address - Street 2:P O BOX 4346
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4346
Mailing Address - Country:US
Mailing Address - Phone:713-794-0001
Mailing Address - Fax:713-793-7661
Practice Address - Street 1:6560 FANNIN ST
Practice Address - Street 2:STE 2208
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2761
Practice Address - Country:US
Practice Address - Phone:713-794-0001
Practice Address - Fax:713-793-7661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0001EJOtherBCBS
TX4458854OtherAETNA PROVIDER #
TX1264459OtherCIGNA PROV. #
TX00660XMedicare PIN