Provider Demographics
NPI:1063613362
Name:ARLINGTON GASTROENTEROLOGY ASSOCIATES, LLP
Entity type:Organization
Organization Name:ARLINGTON GASTROENTEROLOGY ASSOCIATES, LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-394-4300
Mailing Address - Street 1:1001 N WALDROP DR
Mailing Address - Street 2:SUITE 509
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-4705
Mailing Address - Country:US
Mailing Address - Phone:817-394-4300
Mailing Address - Fax:817-394-0200
Practice Address - Street 1:1001 N WALDROP DR
Practice Address - Street 2:SUITE 509
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4705
Practice Address - Country:US
Practice Address - Phone:817-394-4300
Practice Address - Fax:817-394-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0072LZOtherBCBS GROUP NUMBER
TX00293XMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER