Organization
ADVANCED GASTROENTEROLOGY ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUHAMMAD ASIM MD (PRESIDENT)
(917) 336-8422
Entity
Organization
Contact information
Practice address
902 PRESKITT RD STE 300, DECATUR, TX 76234-4101
(214) 415-6845
(972) 377-3156
Mailing address
PO BOX 93477, SOUTHLAKE, TX 76092-9998
(214) 415-6845
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A5686
GROUP PTAN
—
Enumeration date
08/25/2009
Last updated
08/11/2022
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