Provider Demographics
NPI:1952372617
Name:MID VALLEY GASTROENTEROLOGY P A
Entity Type:Organization
Organization Name:MID VALLEY GASTROENTEROLOGY P A
Other - Org Name:RGV GASTRO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:S. MURTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BADIGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-973-2446
Mailing Address - Street 1:902 S AIRPORT DR
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6644
Mailing Address - Country:US
Mailing Address - Phone:956-973-2446
Mailing Address - Fax:956-973-0392
Practice Address - Street 1:902 S AIRPORT DR
Practice Address - Street 2:SUITE 6
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6644
Practice Address - Country:US
Practice Address - Phone:956-973-2446
Practice Address - Fax:956-973-0392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156069001Medicaid
TX156069001Medicaid
TX00438TMedicare ID - Type UnspecifiedGROUP PROVIDER ID