Provider Demographics
NPI:1154973881
Name:TOMBALL GASTROENTEROLOGY ASSOCIATES P.A
Entity type:Organization
Organization Name:TOMBALL GASTROENTEROLOGY ASSOCIATES P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANINDER
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:GURAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-546-0181
Mailing Address - Street 1:155 SCHOOL ST # 250
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-5288
Mailing Address - Country:US
Mailing Address - Phone:281-205-7522
Mailing Address - Fax:281-205-7553
Practice Address - Street 1:155 SCHOOL ST # 250
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-5288
Practice Address - Country:US
Practice Address - Phone:281-205-7522
Practice Address - Fax:281-205-7553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-12
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4224313Medicaid
890982OtherMEDICARE