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General NPI Number Information
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NPI Number | 1053818344
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Entity Type | Organization
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Legal Business Name | TEXAS DIGESTIVE DISEASE CONSULTANTS, PLLC
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Dates
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Enumeration Date | 04/12/2018
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 6317 HARRIS PKWY SUITE 320
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City | FORT WORTH
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State | TX
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Zip | 76132-4256
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Country | US
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Telephone | 682-707-3760
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Fax | 817-945-3778
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Provider Business Mailing Address
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Address Line | 1620 W NORTHWEST HIGHWAY SUITE 100
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City | GRAPEVINE
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State | TX
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Zip | 76051-3119
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Country | US
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Telephone | 817-572-0009
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Fax | 817-945-3778
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Authorized Official
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Title or Position | MANAGING OFFICER
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Name | JAMES WEBER
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Credential | M.D.
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Telephone | 682-707-3760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 31940
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License Number State | TX
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