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General NPI Number Information
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NPI Number | 1285807420
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Entity Type | Organization
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Legal Business Name | GASTROENTEROLOGY CARE CONSULTANTS PA
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 12/28/2011
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Provider Practice Location Address
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Address Line | 750 EUREKA ST SUITE B
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City | WEATHERFORD
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State | TX
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Zip | 76086-6521
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Country | US
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Telephone | 817-599-6222
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Fax | 817-599-8151
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Provider Business Mailing Address
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Address Line | PO BOX 2183
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City | WEATHERFORD
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State | TX
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Zip | 76086-7183
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Country | US
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Telephone | 817-599-6222
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Fax | 817-599-8151
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. SANJEEB SHRESTHA
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Credential | MD
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Telephone | 817-599-6222
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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 |
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License Number State |
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