Healthcare Provider Details

I. General information

NPI: 1285057208
Provider Name (Legal Business Name): EMAF GI, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2014
Last Update Date: 01/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26103 INTERSTATE 45 N SUITE 100
THE WOODLANDS TX
77380-1902
US

IV. Provider business mailing address

12309 WINDING SHORES DR
PEARLAND TX
77584-6100
US

V. Phone/Fax

Practice location:
  • Phone: 281-764-9500
  • Fax: 281-764-9501
Mailing address:
  • Phone: 281-382-9609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: YEMI M FASAKIN
Title or Position: OWNER
Credential: M.D.
Phone: 281-382-9609