Healthcare Provider Details

I. General information

NPI: 1497970867
Provider Name (Legal Business Name): BAY AREA HOUSTON GASTROENTEROLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 06/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 MEDICAL CENTER BLVD SUITE 1400
WEBSTER TX
77598-4052
US

IV. Provider business mailing address

1015 MEDICAL CENTER BLVD SUITE 1400
WEBSTER TX
77598-4052
US

V. Phone/Fax

Practice location:
  • Phone: 281-338-2861
  • Fax: 281-554-2035
Mailing address:
  • Phone: 281-338-2861
  • Fax: 281-554-2035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. STEPHEN C MARCUM
Title or Position: PRESIDENT
Credential: MD
Phone: 281-338-2861