Organization
RICHMOND GASTROENTEROLOGY ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KUMARA S PEDDAMATHAM M.D. (PARTNER)
(281) 342-9530
Entity
Organization
Contact information
Practice address
1601 MAIN ST, STE 401, RICHMOND, TX 77469-3247
(281) 342-9530
(281) 342-9564
Mailing address
1601 MAIN ST, STE 401, RICHMOND, TX 77469-3247
(281) 342-9530
(281) 342-9564
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0082TV
BCBS
TX
05
—
215507901
—
TX
01
—
45D0495676
CLIA HISTOLOGY CERTIFICATE
TX
Enumeration date
03/30/2010
Last updated
02/25/2015
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