Organization
WIFI MEDICAL LLC
Active
Organization
WIFI MEDICAL LLC
Active
Other names
Campus Gastroenterology
Organization subpart
No
Provider details
NPI number
Authorized official
BEN JOSEPH ELIZONDO (MANAGER)
(979) 330-7140
Entity
Organization
Contact information
Practice address
3201 UNIVERSITY DR E STE 320, BRYAN, TX 77802-3478
(970) 330-7140
Mailing address
3201 UNIVERSITY DR E STE 320, BRYAN, TX 77802-3478
(979) 330-7140
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
2080P0206X
Pediatric Gastroenterology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831109909
INDIVIDUAL NPI
TX
Enumeration date
04/05/2021
Last updated
05/03/2024
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