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TEXAS DIGESTIVE DISEASE CONSULTANTS PLLC NPI 1649256546


NPI Information

NPI: 1649256546
Provider Name: TEXAS DIGESTIVE DISEASE CONSULTANTS, PLLC
Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

CLIA Number: 45D0943109

Address:
505 S NOLEN DR
STE A
SOUTHLAKE, TX
ZIP 76092
Phone: (817) 424-1525
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TEXAS DIGESTIVE DISEASE CONSULTANTS, PLLC is a gastroenterology internal medicine in Southlake, TX. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. TEXAS DIGESTIVE DISEASE CONSULTANTS, PLLC NPI is 1649256546. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

505 S NOLEN DR
STE A
SOUTHLAKE, TX
ZIP 76092-167
Phone: (817) 424-1525
Fax: (817) 424-3491

The provider's authorized official is Stephanie Summerall .
The authorized official title is Svp, Payer Relations and has the following contact phone number (214) 424-2200.

The CLIA number assigned to this NPI record is 45D0943109 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/22/2005 and was last updated on 6/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0100XInternal MedicineGastroenterologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1081585402MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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