Organization
NORTHWEST GASTROENTEROLOGY ASSOCIATES P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA MARIE LASKOSKIE (CREDENTIALING COORDINATOR)
(281) 392-5558
Entity
Organization
Contact information
Practice address
425 HOLDERRIETH BLVD, STE. 109, TOMBALL, TX 77375-4543
(281) 357-8882
(281) 357-8886
Mailing address
PO BOX 54, HOUSTON, TX 77001-0054
(281) 357-8882
(281) 357-8886
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
J2958
TX
207RG0100X
Gastroenterology Physician
L3640
TX
Other
Enumeration date
09/22/2006
Last updated
11/14/2007
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