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General NPI Number Information
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NPI Number | 1447405535
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Entity Type | Organization
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Legal Business Name | CLEBURNE DIGESTIVE HEALTH PLLC
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Dates
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Enumeration Date | 11/17/2008
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Last Update Date | 11/17/2018
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Provider Practice Location Address
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Address Line | 1701 WALTER HOLIDAY DR STE 200
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City | CLEBURNE
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State | TX
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Zip | 76033-1189
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Country | US
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Telephone | 817-760-0234
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Fax | 817-641-3355
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Provider Business Mailing Address
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Address Line | 1701 WALTER HOLIDAY DR STE 200
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City | CLEBURNE
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State | TX
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Zip | 76033-1189
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Country | US
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Telephone | 817-760-0234
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Fax | 817-641-3355
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Authorized Official
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Title or Position | PRESIDENT
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Name | YEVGENIY OSTRINSKY
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Credential |
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Telephone | 817-760-0938
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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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