MEDICARE: HOUSTON HEALTH & GASTROINTESTINAL CENTER

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1	OTHER		I DO NOT HAVE ANY OTHER IDENTIFIERS

General Provider Information

NPI Number	:	1366149429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON HEALTH & GASTROINTESTINAL CENTER

Provider Business Mailing Address
First Line	:	2414 ELLA BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-2710
Country	:	US
Telephone Number	:	713-623-2079
Fax Number	:

Provider Business Practice Location Address
First Line	:	2414 ELLA BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-2710
Country	:	US
Telephone Number	:	713-623-2079
Fax Number	:	713-629-0007

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	NATHANIEL P AVILA
Credential	:	MD
Telephone Number	:	281-728-3017

Provider Enumeration Date	:	02/09/2023
Last Update Date	:	02/09/2023

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Directions to “HOUSTON HEALTH & GASTROINTESTINAL CENTER ” Practice Location

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