MEDICARE: GASTROENTEROLOGY & LIVER ASSOCIATES, PLLC

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	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1194028142
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GASTROENTEROLOGY & LIVER ASSOCIATES, PLLC

Provider Business Mailing Address
First Line	:	3030 S GESSNER RD
Second Line	:	SUITE 290
City	:	HOUSTON
State	:	TX
Zip	:	77063-3765
Country	:	US
Telephone Number	:	713-783-4252
Fax Number	:	713-783-4262

Provider Business Practice Location Address
First Line	:	3030 S GESSNER RD
Second Line	:	SUITE 290
City	:	HOUSTON
State	:	TX
Zip	:	77063-3765
Country	:	US
Telephone Number	:	713-783-4252
Fax Number	:	713-783-4262

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. M. RADWAN AL-SABBAGH
Credential	:	M.D.
Telephone Number	:	713-783-4252

Provider Enumeration Date	:	12/14/2010
Last Update Date	:	12/14/2010

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