Provider Demographics
NPI:1780959361
Name:GI ASSOCIATES OF LEWISVILLE, PLLC
Entity type:Organization
Organization Name:GI ASSOCIATES OF LEWISVILLE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-401-8720
Mailing Address - Street 1:475 ELM ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-3762
Mailing Address - Country:US
Mailing Address - Phone:214-222-3571
Mailing Address - Fax:214-222-3601
Practice Address - Street 1:475 ELM ST
Practice Address - Street 2:SUITE 203
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3762
Practice Address - Country:US
Practice Address - Phone:214-222-3571
Practice Address - Fax:214-222-3601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty