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NPI Code Detail

MEDICARE: ANDREI C GASIC M.D.

MEDICARE: ANDREI C GASIC M.D.
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
1174400000XSpecialistH2396TX
2207RG0100XGastroenterologyH2396TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1H2396OTHERTXLICENSE

General Provider Information

NPI Number : 1184623407
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREI C GASIC M.D.
Provider Business Mailing Address
First Line : PO BOX 847176
Second Line :
City : DALLAS
State : TX
Zip : 75284-7176
Country : US
Telephone Number : 903-237-1800
Fax Number : 903-237-1810
Provider Business Practice Location Address
First Line : 707 HOLLYBROOK DR
Second Line : SUITE 503
City : LONGVIEW
State : TX
Zip : 75605-2410
Country : US
Telephone Number : 903-753-3331
Fax Number : 903-753-3491
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 09/04/2012

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Directions to “ ANDREI C GASIC M.D.” Practice Location

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