Organization
TEXAS DIGESTIVE DISEASE CONSULTANTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA KAY LOWERY (CREDENTIALING MANAGER)
(317) 919-9025
Entity
Organization
Contact information
Practice address
1800 PLAZA DR, BEDFORD, TX 76021-6013
(817) 310-4490
(817) 310-4491
Mailing address
950 E STATE HIGHWAY 114 STE 200, SOUTHLAKE, TX 76092-5261
(214) 424-2200
(214) 231-2159
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
45D1067054
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197339801
—
TX
Enumeration date
06/21/2007
Last updated
04/21/2026
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