Gastroenterology Center PA

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

L0986 Issued in TX

Legal business name

GASTROENTEROLOGY CENTER PA

Practice address

11801 South Fwy Ste 140
Burleson, TX 76028-7021

Phone

(817) 551-6161

Fax

(817) 551-6177

NPI assigned

Jan 5, 2018

Organization subpart

No

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

Authorized official

Name

Hani Bismar

Title

Consultant

Phone

(817) 551-6161

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

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

• Mike M Bismar, MD

  • Gastroenterology Physician
  • Burleson, TX
  • NPI 1306816392
  Medicare reassignment Care Compare group NPD
• Katie Fowler, APRN,CNP-C

  • Nurse Practitioner
  • Burleson, TX
  • NPI 1841057270
  Medicare reassignment Care Compare group NPD
• Jose Calderon, PA-C

  • Physician Assistant
  • Burleson, TX
  • NPI 1033506480
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605744000000",
    "number": "1992212492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16657",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761620657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 SOUTH FWY STE 140",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287021",
            "telephone_number": "817-551-6161",
            "fax_number": "817-551-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-05",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A",
        "authorized_official_last_name": "BISMAR",
        "authorized_official_first_name": "HANI",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "817-551-6161"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "L0986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Renee Gardiner, FNP-BC
• Christi S Gardner, RPH
• Christopher William Garrett, MD
• Nicole Garrow
• Gary D Gottfried MD PA
• Gastroenterology Center, PA
• Gateway Hospice Providers LLC
• Susan Gathimba
• Leslie Anne Gayk, LPC
• Gda Neurophysiology PLLC

• Gastroenterology Physician in Burleson, TX
• Providers in Burleson, TX by specialty
• Gastroenterology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.