Organization
GULF COAST GASTROENTEROLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRITIANY BUSH (OFFICE MANAGER)
(979) 297-4033
Entity
Organization
Contact information
Practice address
219 OAK DR S STE A, LAKE JACKSON, TX 77566-5675
(979) 297-4033
(979) 297-4099
Mailing address
104 CIRCLE WAY ST STE B, LAKE JACKSON, TX 77566-5200
(979) 297-4033
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181777701
—
TX
Enumeration date
11/01/2006
Last updated
09/18/2023
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