| Lone Star Gastroenterology Of Abilene, Pllc | |
|
1904 Pine St Ste 1b Abilene TX 79601 | |
| (325) 704-5055 | |
| (325) 704-5056 |
| Full Name | Lone Star Gastroenterology Of Abilene, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1904 Pine St Ste 1b, Abilene, Texas |
| Authorized Official Name and Position | Vivek Reddy Garlapati (SOLE MANAGING MEMBER/OWNER) |
| Authorized Official Contact | 5868640209 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lone Star Gastroenterology Of Abilene, Pllc Po Box 6815 Abilene TX 79608-6815 Ph: (325) 704-5055 | Lone Star Gastroenterology Of Abilene, Pllc 1904 Pine St Ste 1b Abilene TX 79601 Ph: (325) 704-5055 |
| NPI Number | 1518363993 |
|---|---|
| Provider Enumeration Date | 11/12/2014 |
| Last Update Date | 07/04/2018 |
| Medicare PECOS PAC ID | 0648593350 |
|---|---|
| Medicare Enrollment ID | O20150106000194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518363993 | NPI | - | NPPES |
| 343750101 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | P8475 (Texas) | Primary |
| Provider Name | Vivek Garlapati |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1114162211 PECOS PAC ID: 7719031954 Enrollment ID: I20150106000115 |
| Provider Name | Alicia Lynn Pillans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528517935 PECOS PAC ID: 5395028831 Enrollment ID: I20170208001051 |
| Provider Name | Dallas A Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538822010 PECOS PAC ID: 0244621613 Enrollment ID: I20211217001643 |
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