Bryan Gastropath, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

BRYAN GASTROPATH, LLC

Practice address

2206 E Villa Maria Rd
Bryan, TX 77802-2547

Phone

(979) 776-4600

Fax

(979) 774-0877

NPI assigned

Feb 9, 2010

Last updated

Feb 9, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charles Henry Moore, M.D.NPI 1629020011

Title

Managing Partner

Phone

(979) 776-4600

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles Henry Moore, MD

  • Gastroenterology Physician
  • Bryan, TX
  • NPI 1629020011
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265673600000",
    "number": "1225360605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 E VILLA MARIA RD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022547",
            "telephone_number": "979-776-4600",
            "fax_number": "979-774-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 E VILLA MARIA RD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022547",
            "telephone_number": "979-776-4600",
            "fax_number": "979-774-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN GASTROPATH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-09",
        "last_updated": "2010-02-09",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "979-776-4600",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Bryan Emergency Physicians PA
• Bryan Family Medicine Clinic, PA
• Bryan Family Practice PLLC
• Bryan Isd
• Bryan Kidney Center PLLC
• Bryan Medical Associates Medical Association
• Bryan Medical Center, LLC (SignatureCare Medical Center - Bryan)
• Bryan Modern Dentistry, PC (Bryan Modern Dentistry)

• Clinical Medical Laboratory in Bryan, TX
• Providers in Bryan, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.