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General NPI Number Information
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NPI Number | 1669417507
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Entity Type | Organization
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Legal Business Name | DR ATILLA ERTAN
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6560 FANNIN STE 2208
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City | HUSTON
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State | TX
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Zip | 77030
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Country | US
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Telephone | 713-796-0001
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Fax | 713-793-7661
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Provider Business Mailing Address
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Address Line | 6560 FANNIN ST STE 2208
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City | HOUSTON
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State | TX
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Zip | 77030-2761
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Country | US
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Telephone | 713-794-0001
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Fax | 713-793-7661
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Authorized Official
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Title or Position | GASTROENTEROLOGIST
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Name | PROF. ATILLA ERTAN
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Credential | MD
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Telephone | 713-794-0001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1036559
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA02055
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License Number State | TX
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