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General NPI Number Information
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NPI Number | 1720044902
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Entity Type | Organization
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Legal Business Name | SOUTHEAST TEXAS GASTROENTEROLOGY ASSOCIATES, P.A.
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 01/17/2008
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Provider Practice Location Address
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Address Line | 950 N 14TH ST SUITE 100
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City | BEAUMONT
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State | TX
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Zip | 77702-1101
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Country | US
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Telephone | 406-833-5858
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Fax | 403-833-1155
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Provider Business Mailing Address
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Address Line | 950 N 14TH ST SUITE 100
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City | BEAUMONT
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State | TX
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Zip | 77702-1101
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Country | US
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Telephone | 406-833-5858
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Fax | 403-833-1155
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH WILLIAM HOLLAND III
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Credential | M.D.
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Telephone | 409-833-5858
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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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