MEDICARE: INTEGRAL GASTROENTEROLOGY CENTER, P.A.

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	L9755	TX

General Provider Information

NPI Number	:	1275534349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRAL GASTROENTEROLOGY CENTER, P.A.

Provider Business Mailing Address
First Line	:	2950 FM 2920 RD STE 180
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-3698
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2950 FM 2920 RD STE 180
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388
Country	:	US
Telephone Number	:	281-880-4887
Fax Number	:	281-880-4889

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VENODHAR RAO JULAPALLI
Credential	:	M.D.
Telephone Number	:	281-880-4887

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	06/15/2018

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