Active NPI
Digestive Disease Consultants PA
- Gastroenterology Physician
- Humble, TX
National Provider Identifier
1376629964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- Legal business name
- DIGESTIVE DISEASE CONSULTANTS PA
- Practice address
- 9816 Memorial Blvd
#206
Humble, TX 77338 - Phone
- (281) 446-8114
- Fax
- (281) 446-1158
- NPI assigned
- Oct 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Starr Lee Wallace, LVN
- Title
- LVN Office Manager
- Phone
- (281) 446-8114
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | Primary |
Addresses
Primary practice location
9816 Memorial Blvd
#206
Humble, TX 77338
Mailing address
9816 Memorial Blvd
#206
Humble, TX 77338
Phone (281) 446-8114
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 081671201 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gastroenterology Physician
- Humble, TX
- NPI 1235326828
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1215561600000",
"number": "1376629964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9816 MEMORIAL BLVD",
"address_2": "#206",
"city": "HUMBLE",
"state": "TX",
"postal_code": "77338",
"telephone_number": "281-446-8114",
"fax_number": "281-446-1158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9816 MEMORIAL BLVD",
"address_2": "#206",
"city": "HUMBLE",
"state": "TX",
"postal_code": "77338",
"telephone_number": "281-446-8114",
"fax_number": "281-446-1158"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DIGESTIVE DISEASE CONSULTANTS PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-27",
"last_updated": "2008-07-09",
"status": "A",
"authorized_official_last_name": "WALLACE",
"authorized_official_first_name": "STARR",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "LVN OFFICE MANAGER",
"authorized_official_telephone_number": "281-446-8114",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "LVN"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "081671201",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Humble, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.