Provider Demographics
NPI:1104085919
Name:DIGESTIVE CENTER ASSOCIATES PLLC
Entity type:Organization
Organization Name:DIGESTIVE CENTER ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EPHRAIM
Authorized Official - Middle Name:E
Authorized Official - Last Name:NSIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-321-3008
Mailing Address - Street 1:16107 KENSINGTON DR
Mailing Address - Street 2:SUITE 136
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4224
Mailing Address - Country:US
Mailing Address - Phone:832-321-3008
Mailing Address - Fax:832-321-5795
Practice Address - Street 1:701 S FRY RD
Practice Address - Street 2:SUITE 220
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2255
Practice Address - Country:US
Practice Address - Phone:832-321-3008
Practice Address - Fax:832-321-5795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-06
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5859207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX198103701Medicaid
TX0089RVOtherBCBS
DO2790OtherMEDICARE RAILROAD
TX00Z916Medicare PIN