Provider Demographics
NPI:1548554934
Name:GASTROENTEROLOGY ASSOCIATES OF NORTH HOUSTON, P.A.
Entity type:Organization
Organization Name:GASTROENTEROLOGY ASSOCIATES OF NORTH HOUSTON, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:UDAYINI
Authorized Official - Middle Name:
Authorized Official - Last Name:KODALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-813-5755
Mailing Address - Street 1:PO BOX 131898
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77393-1898
Mailing Address - Country:US
Mailing Address - Phone:832-813-5755
Mailing Address - Fax:832-813-8096
Practice Address - Street 1:920 MEDICAL PLAZA DR
Practice Address - Street 2:STE 290
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3260
Practice Address - Country:US
Practice Address - Phone:832-813-5755
Practice Address - Fax:832-813-8096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-03
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0463207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty