# WEST TEXAS DIGESTIVE DISEASE CENTER, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720299381
- **Authorized official:** DR. HOUSSAM AL KHARRAT M.D. (PRESIDENT)
- **Authorized official phone:** (806) 788-4368

## Contact information

- **Practice address:** 5115 80TH ST, LUBBOCK, TX 79424-3017
- **Practice address phone:** (806) 788-4368
- **Practice address fax:** (806) 788-4369
- **Mailing address:** PO BOX 93128, LUBBOCK, TX 79493-3128
- **Mailing address phone:** (806) 788-4368
- **Mailing address fax:** (806) 788-4369

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | — |
| 207RG0100X | Gastroenterology Physician | — | — | — |
| 261QM2500X | Medical Specialty Clinic/Center | L8588 | TX | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 05/25/2007
- **Last updated:** 03/15/2023