Provider Demographics
NPI:1366149429
Name:HOUSTON HEALTH & GASTROINTESTINAL CENTER
Entity type:Organization
Organization Name:HOUSTON HEALTH & GASTROINTESTINAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:AVILA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-728-3017
Mailing Address - Street 1:2414 ELLA BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-2710
Mailing Address - Country:US
Mailing Address - Phone:713-623-2079
Mailing Address - Fax:
Practice Address - Street 1:2414 ELLA BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-2710
Practice Address - Country:US
Practice Address - Phone:713-623-2079
Practice Address - Fax:713-629-0007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1OtherI DO NOT HAVE ANY OTHER IDENTIFIERS