Basic Information
| Provider Information | |||||||||
| NPI: | 1780700336 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTH HOUSTON GASTROENTEROLOGY CLINIC PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1140 CYPRESS STATION DR STE 306 | ||||||||
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| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770903002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814403618 | ||||||||
| FaxNumber: | 2814406573 | ||||||||
| Practice Location | |||||||||
| Address1: | 1140 CYPRESS STATION DR STE 306 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770903002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814403618 | ||||||||
| FaxNumber: | 2814406573 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2007 | ||||||||
| LastUpdateDate: | 03/05/2008 | ||||||||
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| AuthorizedOfficialLastName: | WINSTON | ||||||||
| AuthorizedOfficialFirstName: | BARRY | ||||||||
| AuthorizedOfficialMiddleName: | DAVID | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2814403618 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | E1185 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.