=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164469631
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DIGESTIVE & LIVER DISEASE CONSULTANTS, P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/01/2006
-----------------------------------------------------
Last Update Date | 01/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 275 LANTERN BEND DR STE. 200
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77090-2831
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-440-0101
-----------------------------------------------------
Fax | 855-404-4345
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 275 LANTERN BEND DR STE. 200
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77090-2831
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-440-0101
-----------------------------------------------------
Fax | 281-440-6441
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | SARAH FLEMING
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 281-453-2026
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number | 207RG0100X
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------