MEDICARE: ATILLA ERTAN MD 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		TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0001EJ	OTHER	TX	BCBS
2	4458854	OTHER	TX	AETNA PROVIDER #
3	1264459	OTHER	TX	CIGNA PROV. #

General Provider Information

NPI Number	:	1740486810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATILLA ERTAN MD PA

Provider Business Mailing Address
First Line	:	DEPT 497
Second Line	:	P O BOX 4346
City	:	HOUSTON
State	:	TX
Zip	:	77210-4346
Country	:	US
Telephone Number	:	713-794-0001
Fax Number	:	713-793-7661

Provider Business Practice Location Address
First Line	:	6560 FANNIN ST
Second Line	:	STE 2208
City	:	HOUSTON
State	:	TX
Zip	:	77030-2761
Country	:	US
Telephone Number	:	713-794-0001
Fax Number	:	713-793-7661

Authorized Official
Title or Position	:	GASTROENTEROLOGIST
Name	:	ATILLA ERTAN
Credential	:	MD PA
Telephone Number	:	713-794-0001

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	11/28/2007

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Directions to “ATILLA ERTAN MD PA ” Practice Location

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