Provider Demographics
NPI:1427695618
Name:TEXAS DIGESTIVE DISEASE CONSULTANTS, PLLC
Entity type:Organization
Organization Name:TEXAS DIGESTIVE DISEASE CONSULTANTS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEILER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-424-2200
Mailing Address - Street 1:PO BOX 35629
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-0629
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9103 JEFFERSON HWY STE 200
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-2440
Practice Address - Country:US
Practice Address - Phone:817-572-0009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXAS DIGESTIVE DISEASE CONSULTANTS, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-06
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAPHY.008013-IROtherLOUISIANA STATE BOARD PHARMACY