| Waco Gastroenterology Associates | |
|
364 Richland West Cir Suite A Waco TX 76712-7919 | |
| (254) 537-0911 | |
| (254) 537-0313 |
| Full Name | Waco Gastroenterology Associates |
|---|---|
| Speciality | Internal Medicine |
| Location | 364 Richland West Cir, Waco, Texas |
| Authorized Official Name and Position | Kacy Baitz (ADMINISTRATOR) |
| Authorized Official Contact | 2545370911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waco Gastroenterology Associates 364 Richland West Cir Suite A Waco TX 76712-7919 Ph: (254) 537-0911 | Waco Gastroenterology Associates 364 Richland West Cir Suite A Waco TX 76712-7919 Ph: (254) 537-0911 |
| NPI Number | 1215987490 |
|---|---|
| Provider Enumeration Date | 05/11/2006 |
| Last Update Date | 02/29/2024 |
| Medicare PECOS PAC ID | 5991795056 |
|---|---|
| Medicare Enrollment ID | O20040512001400 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215987490 | NPI | - | NPPES |
| 081724901 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| 207ZC0006X | Pathology - Clinical Pathology | (* (Not Available)) | Secondary |
| Provider Name | Rohini C Krishnan |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1538149406 PECOS PAC ID: 8729987292 Enrollment ID: I20040103000031 |
| Provider Name | Hari B Ancha |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1992755128 PECOS PAC ID: 9436162112 Enrollment ID: I20060725000151 |
| Provider Name | Bryan John Hanysak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720179203 PECOS PAC ID: 2961583141 Enrollment ID: I20080114000383 |
| Provider Name | Edward D Contreras |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1609826445 PECOS PAC ID: 5193637692 Enrollment ID: I20101103000024 |
| Provider Name | Edward Dean Carpenter |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1306896840 PECOS PAC ID: 8921910423 Enrollment ID: I20101103000034 |
| Provider Name | James W Boss |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1164469482 PECOS PAC ID: 5294647798 Enrollment ID: I20101103000072 |
| Provider Name | Christina Anne Levings |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1649497900 PECOS PAC ID: 0941347090 Enrollment ID: I20111209000433 |
| Provider Name | Charles D Osborn |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1891775953 PECOS PAC ID: 1355420423 Enrollment ID: I20120305000642 |
| Provider Name | Jena Suanne Mann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366857757 PECOS PAC ID: 1759508039 Enrollment ID: I20140811000422 |
| Provider Name | Patrice Ihry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083018220 PECOS PAC ID: 6406170588 Enrollment ID: I20150120001819 |
| Provider Name | Hanumantha Rao Ancha |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1710140272 PECOS PAC ID: 5799092821 Enrollment ID: I20160418002150 |
| Provider Name | Christopher Jones |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1346538139 PECOS PAC ID: 3375830706 Enrollment ID: I20160928001185 |
| Provider Name | Denise Landon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306340245 PECOS PAC ID: 6709149800 Enrollment ID: I20180423002352 |
| Provider Name | Shamyal Khan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972981843 PECOS PAC ID: 4587945670 Enrollment ID: I20180625002930 |
| Provider Name | Charles B Rives |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1083057814 PECOS PAC ID: 0446541965 Enrollment ID: I20190805000645 |
| Provider Name | Ashleigh Grace Holden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821624628 PECOS PAC ID: 6103256607 Enrollment ID: I20200424000641 |
| Provider Name | Maggie Middlebrooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255901690 PECOS PAC ID: 4183026479 Enrollment ID: I20210708002868 |
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