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NPI Code Detail

MEDICARE: TEXAS DIGESTIVE DISEASE CONSULTANTS PLLC

MEDICARE: TEXAS DIGESTIVE DISEASE CONSULTANTS 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
1207RG0100XGastroenterology Physician

General Provider Information

NPI Number : 1508400425
Entity Type Code : Organization
Provider Name (Legal Business Name) : TEXAS DIGESTIVE DISEASE CONSULTANTS PLLC
Provider Business Mailing Address
First Line : PO BOX 35629
Second Line :
City : DALLAS
State : TX
Zip : 75235-0629
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3901 PARKWAY CIR STE 550
Second Line :
City : SPRINGDALE
State : AR
Zip : 72762-6362
Country : US
Telephone Number : 479-346-1850
Fax Number :
Authorized Official
Title or Position : CREDENTIALING MANAGER
Name : KRISTINA KAY LOWERY
Credential :
Telephone Number : 469-930-3077
Provider Enumeration Date : 11/04/2019
Last Update Date : 01/07/2026

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Directions to “TEXAS DIGESTIVE DISEASE CONSULTANTS PLLC ” Practice Location

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