Nacogdoches Gastroenterology, P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

J3164 Issued in TX

Legal business name

NACOGDOCHES GASTROENTEROLOGY, P.A.

Practice address

1018 N Mound St
Suite 105
Nacogdoches, TX 75961-4492

Phone

(936) 569-6449

Fax

(936) 569-2458

NPI assigned

Aug 3, 2006

Last updated

Nov 10, 2011By 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

Mrs. Jill Griffin

Title

Office Manager

Phone

(936) 569-6449

Specialties & licenses 1

Addresses

Other names 1

• Michael E. Mollot, M.D. Other name

Locations

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320883200000",
    "number": "1598772188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 N MOUND ST",
            "address_2": "SUITE 105",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614492",
            "telephone_number": "936-569-6449",
            "fax_number": "936-569-2458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 N MOUND ST",
            "address_2": "SUITE 105",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614492",
            "telephone_number": "936-569-6449",
            "fax_number": "936-569-2458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NACOGDOCHES GASTROENTEROLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2011-11-10",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "936-569-6449",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "J3164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael E. Mollot, M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Specialist in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.