Center for Digestive Disease

129 Vision Park Blvd, Suite 307

Shenandoah, TX 77384

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Tel: 936-321-5440

Fax: 936-271-4909

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OUTPATIENT APPOINTMENT

Disclaimer: In note section please add

Referring MD/Primary Care

Current Medication with dosage

Past Medical History

Surgical History

Family History

Social History

Allergies

Recent Hospitalizations