Organization
GASTROENTEROLOGY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD I GREEN MD (PRESIDENT)
(210) 490-0202
Entity
Organization
Contact information
Practice address
540 MADISON OAK DR, SUITE #520, SAN ANTONIO, TX 78258-3943
(210) 490-0202
(210) 490-0648
Mailing address
540 MADISON OAK DR, SUITE #520, SAN ANTONIO, TX 78258-3943
(210) 490-0202
(210) 490-0648
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
D8539
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00AB48
BC ID
TX
05
—
Z000AB485
—
TX
Enumeration date
04/13/2007
Last updated
05/10/2011
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