| NPI | 1487683587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG J. GAVIN Network Administrator 318-212-3787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2020-08-22 |