Provider Demographics
NPI:1285807420
Name:GASTROENTEROLOGY CARE CONSULTANTS PA
Entity type:Organization
Organization Name:GASTROENTEROLOGY CARE CONSULTANTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJEEB
Authorized Official - Middle Name:
Authorized Official - Last Name:SHRESTHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-599-6222
Mailing Address - Street 1:PO BOX 2183
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-7183
Mailing Address - Country:US
Mailing Address - Phone:817-599-6222
Mailing Address - Fax:817-599-8151
Practice Address - Street 1:750 EUREKA ST
Practice Address - Street 2:SUITE B
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-6521
Practice Address - Country:US
Practice Address - Phone:817-599-6222
Practice Address - Fax:817-599-8151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty