NPIMap

Organization Active NPI

MD Gastroenterology Anesthesia Services, PLLC

  • Anesthesiology Physician
  • Katy, TX
National Provider Identifier
1386039360
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
L7210 Issued in TX
Legal business name
MD GASTROENTEROLOGY ANESTHESIA SERVICES, PLLC
Practice address
25230 Kinsland Blvd
Ste 102
Katy, TX 77494-2097
Phone
(713) 429-4828
Fax
(713) 429-4866
NPI assigned
Apr 6, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Authorized official

Name
Radha Tamerisa, MDNPI 1366440653
Title
Sole MBR
Phone
(713) 540-8997

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X L7210 TX Primary

Addresses

Primary practice location

25230 Kinsland Blvd
Ste 102
Katy, TX 77494-2097

Mailing address

25230 Kinsland Blvd
Ste 102
Katy, TX 77494-2097
Phone (713) 429-4828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151231000386 TX Part B Supplier - Clinic/Group Practice 8123320520 Receives reassigned benefits from 8 practitioners
Practice locations: Katy, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1386039360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25230 KINSLAND BLVD",
            "address_2": "STE 102",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774942097",
            "telephone_number": "713-429-4828",
            "fax_number": "713-429-4866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25230 KINSLAND BLVD",
            "address_2": "STE 102",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774942097",
            "telephone_number": "713-429-4828",
            "fax_number": "713-429-4866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD GASTROENTEROLOGY ANESTHESIA SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-06",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-21",
        "status": "A",
        "authorized_official_last_name": "TAMERISA",
        "authorized_official_first_name": "RADHA",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "713-540-8997",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "L7210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; 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.

Verify at the official NPI Registry.