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General NPI Number Information
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NPI Number | 1578563813
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Entity Type | Organization
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Legal Business Name | COLON LIVER GASTRO CONSULTANTS PLLC
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 16651 SOUTHWEST FWY SUITE 370
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City | SUGAR LAND
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State | TX
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Zip | 77479-2345
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Country | US
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Telephone | 832-667-7355
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Fax | 281-565-2009
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Provider Business Mailing Address
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Address Line | PO BOX 711115
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City | HOUSTON
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State | TX
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Zip | 77271-1115
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Country | US
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Telephone | 832-667-7355
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Fax | 281-565-2009
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEKA GAJULA
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Credential | MD
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Telephone | 832-667-7355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #4
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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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