Organization
TEXAS GI ENDOSCOPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAYEZ G SELF MD (MANAGING PARTNER MEDICAL DIRECTOR)
(972) 270-3590
Entity
Organization
Contact information
Practice address
2704 N GALLOWAY, STE 102, MESQUITE, TX 75150
(972) 270-3590
(972) 270-3572
Mailing address
2704 N GALLOWAY, STE 102, MESQUITE, TX 75150
(972) 270-3590
(972) 270-3572
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
007938
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HH000A
BCBS
TX
Enumeration date
07/17/2006
Last updated
08/22/2020
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