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General NPI Number Information
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NPI Number | 1336365766
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Entity Type | Organization
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Legal Business Name | GASTROENTEROLOGY CENTER OF LAREDO, PA
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 01/11/2013
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Provider Practice Location Address
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Address Line | 6801 MCPHERSON RD SUITE 330
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City | LAREDO
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State | TX
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Zip | 78041-6402
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Country | US
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Telephone | 956-724-9219
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Fax | 956-724-4120
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Provider Business Mailing Address
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Address Line | 6801 MCPHERSON RD SUITE 330
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City | LAREDO
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State | TX
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Zip | 78041-6402
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Country | US
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Telephone | 956-724-9219
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Fax | 956-724-4120
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Authorized Official
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Title or Position | OWNER
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Name | ANTHONY R. GALAN
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Credential | MD
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Telephone | 956-724-9219
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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 | K9064
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License Number State | TX
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