NPIMap

Organization Active NPI

West Texas Digestive Disease Center, PA

  • Medical Specialty Clinic/Center
  • Lubbock, TX
National Provider Identifier
1720299381
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
L8588 Issued in TX
Legal business name
WEST TEXAS DIGESTIVE DISEASE CENTER, PA
Practice address
5115 80TH St
Lubbock, TX 79424-3017
Phone
(806) 788-4368
Fax
(806) 788-4369
NPI assigned
May 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Authorized official

Name
Dr. Houssam Al Kharrat, M.D.NPI 1295734424
Title
President
Phone
(806) 788-4368

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RG0100X
Medical Specialty Clinic/Center 261QM2500X L8588 TX Primary
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

5115 80TH St
Lubbock, TX 79424-3017

Mailing address

PO Box 93128
Lubbock, TX 79493-3128
Phone (806) 788-4368

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071011000263 TX Part B Supplier - Clinic/Group Practice 7416043161 Receives reassigned benefits from 13 practitioners
Practice locations: Lubbock, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2169878West Texas Digestive Disease Center PA5115-80TH Street, Lubbock, TX 79424ComplianceMay 9, 2027

National Provider Directory

National Provider Directory

Locations

5115 80th St
Ste 100
Lubbock, TX 79424

5115 80th St
Lubbock, TX 79424
Phone (806) 788-4368

2424 50th St
Rm 300
Lubbock, TX 79412
Phone (806) 743-2424

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1720299381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93128",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794933128",
            "telephone_number": "806-788-4368",
            "fax_number": "806-788-4369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 80TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794243017",
            "telephone_number": "806-788-4368",
            "fax_number": "806-788-4369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST TEXAS DIGESTIVE DISEASE CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "AL KHARRAT",
        "authorized_official_first_name": "HOUSSAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "806-788-4368",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "TX",
            "license": "L8588",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.