Organization
PANHANDLE GASTROENTEROLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KULDIP S BANWAIT MD (CEO)
(806) 354-9400
Entity
Organization
Contact information
Practice address
800 QUAIL CREEK DR, SUITE 101, AMARILLO, TX 79124-1634
(806) 354-9400
(806) 354-9403
Mailing address
PO BOX 50537, AMARILLO, TX 79159-0537
(806) 354-9400
(806) 354-9403
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
M4993
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00149690
DPS
TX
01
—
0031QW
BCBS PROVIDER GROUP NO.
TX
01
—
00Y904
MEDICARE GROUP BILLING NUMBER
TX
05
—
184296503
—
TX
01
—
197441201
MEDICAID GROUP BILLING NUMBER
TX
01
—
7830853
AETNA PROVIDER ID
TX
01
—
8AW200
BCBS PROVIDER NO.
TX
01
—
8J2689
JO WYATT CLINIC MEDICARE NUMBER
TX
01
—
DN1508
RAILROAD MEDICARE
—
01
—
M4993
PHYSICIAN PERMIT
TX
Enumeration date
01/24/2008
Last updated
03/07/2023
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