BRYAN GASTROPATH, LLC (NPI# 1225360605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225360605 |
| Entity Type | Organization |
| Organization Name | BRYAN GASTROPATH, LLC |
| Practice Address |
2206 E Villa Maria Rd Bryan TX 77802-2547 |
| Practice Telephone | 9797764600 |
| Practice Fax Number | 9797740877 |
| Mailing Telephone | 9797764600 |
| Mailing Fax Number | 9797740877 |
| Enumeration Date | 2010-02-09 |
| Last Update Date | 2010-02-09 |
| Authorized Official Name | CHARLES HENRY MOORE (MANAGING PARTNER) |
| Authorized Official Telephone | 9797764600 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Street Address |
2206 E VILLA MARIA RD |
| City | BRYAN |
| State | TX |
| Zip Code | 77802-2547 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629020011 | Charles Henry Moore | Internal Medicine | 2206 E Villa Maria Rd, Bryan, TX 77802-2547 | 2006-05-16 |
| 1073056248 | Hannah Helm | Physician Assistant | 2206 E Villa Maria Rd, Bryan, TX 77802-2547 | 2016-11-21 |
| 1558751834 | Anesthesia Associates of Bryan LLC | Nurse Anesthetist, Certified Registered | 2206 E Villa Maria Rd, Bryan, TX 77802-2547 | 2015-01-26 |
| 1588820054 | Joshua David Sultz | Internal Medicine | 2206 E Villa Maria Rd, Bryan, TX 77802-2547 | 2008-08-04 |
| 1922263722 | David J Case | Internal Medicine | 2206 E Villa Maria Rd, Bryan, TX 77802-2547 | 2008-07-22 |
| 1811061930 | William H Lovett IIi | Physician Assistant | 2206 E Villa Maria Rd, Bryan, TX 77802-2547 | 2006-11-20 |
| 1639260763 | Central Texas Digestive Disease Association, Pa | Internal Medicine | 2206 E Villa Maria Rd, Bryan, TX 77802-2547 | 2006-09-27 |
| 1316058266 | Phyllis Clara Chang | Internal Medicine | 2206 E Villa Maria Rd, Bryan, TX 77802-2547 | 2006-08-31 |
| 1043321987 | Brent Morgan Gray | Internal Medicine | 2206 E Villa Maria Rd, Bryan, TX 77802-2547 | 2006-08-31 |
| 1366553380 | L. Henry Pham | Internal Medicine | 2206 E Villa Maria Rd, Bryan, TX 77802-2547 | 2006-08-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013476951 | Andrea Pittman | Student in an Organized Health Care Education/Training Program | Primary Care Medicine Department, College of Medicine, 2900 East 29th Street, Bryan, TX 77802 | 2019-03-19 |
| 1942789110 | Alicia Diane Ates | Dentist | 3001 Wildflower Drive, Suite #511, Bryan, TX 77802 | 2018-08-09 |
| 1588151682 | Metx LLC | Audiologist-Hearing Aid Fitter | 3030 E 29th St Ste 102, Bryan, TX 77802 | 2018-04-16 |
| 1073047437 | Abbi Messer | Family Medicine | 2900 29th Street, Suite 100, Bryan, TX 77802 | 2017-04-12 |
| 1265885180 | Scott Andrew Thayer | Dentist | 3811 Stoneparc Dr, Bryan, TX 77802 | 2016-07-15 |
| 1255792123 | Phoebe Mathew | Pharmacist | 3312 East 29th Street, Bryan, TX 77802 | 2016-03-18 |
| 1801253810 | Pearl Coleshill | Specialist/Technologist | 3121 University Drive E., Suite 100, Bryan, TX 77802 | 2016-01-21 |
| 1265847750 | Wesley Danielle Daniels | Dietitian, Registered | 3900-c Carter Creek Pkway, Bryan, TX 77802 | 2014-06-24 |
| 1235549098 | Regina V. Robertson | Home Health | 1121 Briarcrest Dr., Suite 102, Bryan, TX 77802 | 2014-05-02 |
| 1982024238 | Lampstand Nursing and Rehabilitation, Lp | Skilled Nursing Facility | 2001 E 29th Street, Bryan, TX 77802 | 2014-04-24 |
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| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316235005 | H-e-b, Lp | Clinical Medical Laboratory | 1609 N Texas Ave, Bryan, TX 77803 | 2011-07-14 |
| 1023275823 | Dj Global Solutions LLC | Clinical Medical Laboratory | 4015 S Texas Ave, Bryan, TX 77802-4022 | 2008-05-20 |
| 1780793109 | H-e-b, Lp | Clinical Medical Laboratory | 725 E Villa Maria Rd Ste 1300, Bryan, TX 77802 | 2006-08-30 |
| 1568730851 | St. Joseph Regional Health Center | Clinical Medical Laboratory | 2801 Franciscan Dr, Bryan, TX 77802-2544 | 2011-12-01 |
| 1154522282 | Midwest Community Health Associates | Clinical Medical Laboratory | 442 W High St, Bryan, OH 43506-1681 | 2007-05-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.