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LAKESIDE GASTROENTEROLOGY AND LIVER SPECIALISTS PLLC NPI 1033439781


NPI Information

NPI: 1033439781
Provider Name: LAKESIDE GASTROENTEROLOGY AND LIVER SPECIALISTS, PLLC
Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

CLIA Number: 45D2298828

Address:
690 S LOOP 336 W STE 215
CONROE, TX
ZIP 77304
Phone: (936) 828-3962
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LAKESIDE GASTROENTEROLOGY AND LIVER SPECIALISTS, PLLC is a gastroenterology internal medicine in Conroe, TX. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. LAKESIDE GASTROENTEROLOGY AND LIVER SPECIALISTS, PLLC NPI is 1033439781. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

690 S LOOP 336 W STE 215
CONROE, TX
ZIP 77304-322
Phone: (936) 828-3962

The provider's authorized official is Nelson A Tajong .
The authorized official title is Owner and has the following contact phone number (410) 530-5310.

The CLIA number assigned to this NPI record is 45D2298828 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/4/2010 and was last updated on 10/29/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0100XInternal MedicineGastroenterologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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