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General NPI Number Information
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NPI Number | 1275619082
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Entity Type | Organization
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Legal Business Name | PASADENA GASTROENTEROLOGY ASSOCIATES, P.A.
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 03/02/2020
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Provider Practice Location Address
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Address Line | 6243 FAIRMONT PKWY STE 203A
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City | PASADENA
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State | TX
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Zip | 77505-4047
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Country | US
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Telephone | 713-946-9513
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Fax | 713-946-7210
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Provider Business Mailing Address
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Address Line | 4001 PRESTON AVE SUITE 125
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City | PASADENA
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State | TX
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Zip | 77505-2069
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Country | US
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Telephone | 713-946-9513
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Fax | 713-946-7210
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Authorized Official
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Title or Position | ADMIN
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Name | KAREN RAINES
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Credential |
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Telephone | 713-946-9513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | F3457
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License Number State | TX
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