MEDICARE: SPRING GASTROENTEROLOGY ASSOCIATES PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	L2481	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033235817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPRING GASTROENTEROLOGY ASSOCIATES PA

Provider Business Mailing Address
First Line	:	26103 I 45 NORTH
Second Line	:	SUITE 100
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-1343
Country	:	US
Telephone Number	:	281-583-5000
Fax Number	:	281-583-5099

Provider Business Practice Location Address
First Line	:	25440 INTERSTATE 45 N
Second Line	:	SUITE 200
City	:	THE WOODLANDS
State	:	TX
Zip	:	77386-1343
Country	:	US
Telephone Number	:	281-583-5000
Fax Number	:	281-583-5099

Authorized Official
Title or Position	:	OWNER/PARTNER
Name	:	RAVI MOPARTY
Credential	:	MD
Telephone Number	:	281-583-5000

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	07/05/2013

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