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General NPI Number Information
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NPI Number | 1033250105
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Entity Type | Organization
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Legal Business Name | SOUTHWESTERN DIGESTIVE HEALTH PHYSICIANS, PA
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 601 S CLAY ST STE 108
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City | ENNIS
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State | TX
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Zip | 75119-5771
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Country | US
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Telephone | 972-875-1800
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Fax | 972-875-1490
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Provider Business Mailing Address
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Address Line | 601 S CLAY ST STE 108
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City | ENNIS
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State | TX
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Zip | 75119-5771
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Country | US
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Telephone | 972-875-1800
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Fax | 972-875-1490
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN DANIEL ABDULIAN
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Credential | MD
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Telephone | 972-875-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | M2891
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License Number State | TX
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