Organization
BRYAN GASTROPATH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES HENRY MOORE M.D. (MANAGING PARTNER)
(979) 776-4600
Entity
Organization
Contact information
Practice address
2206 E VILLA MARIA RD, BRYAN, TX 77802-2547
(979) 776-4600
(979) 774-0877
Mailing address
2206 E VILLA MARIA RD, BRYAN, TX 77802-2547
(979) 776-4600
(979) 774-0877
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
02/09/2010
Last updated
02/09/2010
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