MEDICARE: GASTROINTESTINAL 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

General Provider Information

NPI Number	:	1427824747
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GASTROINTESTINAL ASSOCIATES, PA

Provider Business Mailing Address
First Line	:	PO BOX 35629
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-0629
Country	:	US
Telephone Number	:	214-424-2200
Fax Number	:

Provider Business Practice Location Address
First Line	:	348 CROSSGATES BLVD STE 1300
Second Line	:
City	:	BRANDON
State	:	MS
Zip	:	39042-2687
Country	:	US
Telephone Number	:	601-825-2811
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JAMES J WEBER
Credential	:
Telephone Number	:	214-424-2213

Provider Enumeration Date	:	11/28/2023
Last Update Date	:	11/28/2023

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