Provider Demographics
NPI:1790819787
Name:HOUSTON GASTROINTESTINAL & LIVER CLINIC PA
Entity type:Organization
Organization Name:HOUSTON GASTROINTESTINAL & LIVER CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SREELATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-773-1800
Mailing Address - Street 1:7737 SOUTHWEST FREEWAY
Mailing Address - Street 2:SUITE 968
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074
Mailing Address - Country:US
Mailing Address - Phone:713-773-1800
Mailing Address - Fax:713-773-1809
Practice Address - Street 1:7737 SOUTHWEST FREEWAY
Practice Address - Street 2:SUITE 968
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074
Practice Address - Country:US
Practice Address - Phone:713-773-1800
Practice Address - Fax:713-773-1809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144905001Medicaid
TX8809M0Medicare ID - Type Unspecified
TX144905001Medicaid
TX144905001Medicaid