Organization
GASTROENTEROLOGY CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANI BISMAR (CONSULTANT)
(817) 551-6161
Entity
Organization
Contact information
Practice address
11801 SOUTH FWY STE 140, BURLESON, TX 76028-7021
(817) 551-6161
(817) 551-6177
Mailing address
PO BOX 16657, FORT WORTH, TX 76162-0657
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
L0986
TX
Other
Enumeration date
01/05/2018
Last updated
11/19/2020
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