1740888676 NPI number — GI CARE OF COLORADO PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740888676 NPI number — GI CARE OF COLORADO PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GI CARE OF COLORADO PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ASSOCIATES IN GASTROENTEROLOGY, DIVISION OF GI CARE OF COLORADO
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740888676
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/15/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 INVERNESS DR E STE 220
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ENGLEWOOD
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80112-5612
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-788-8888
Provider Business Mailing Address Fax Number:
303-768-8774

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2940 N CIRCLE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80909-1160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-635-7321
Provider Business Practice Location Address Fax Number:
719-635-2510
Provider Enumeration Date:
10/13/2020

Additional Information

Authorized Official

Authorized Official Last Name:
GARZA
Authorized Official First Name:
AUSTIN
Authorized Official Middle Name:
EDWARD
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
719-635-7321

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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