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General NPI Number Information
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NPI Number | 1528220654
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Entity Type | Organization
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Legal Business Name | NORTH TEXAS TRIANGLE GASTROENTEROLOGY GROUP LTD LLP
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 2900 N INTERSTATE 35 STE 101
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City | DENTON
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State | TX
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Zip | 76201-5142
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Country | US
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Telephone | 214-394-6691
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Fax | 940-898-8247
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Provider Business Mailing Address
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Address Line | 2900 N INTERSTATE 35 STE 101
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City | DENTON
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State | TX
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Zip | 76201-5142
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Country | US
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Telephone | 214-394-6691
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Fax | 940-898-8247
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Authorized Official
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Title or Position | PRESIDENT OF THE GENERAL PARTNER
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Name | GANG QUAN
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Credential | MD
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Telephone | 214-399-6691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | L4662
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License Number State | TX
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