Nathaniel Avila, MD
Gastroenterology · Shenandoah, TXNPI 1346683323
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 34 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 18 manufacturers, the largest accounting for just 22.4% — the pattern of someone who eats at a lot of different presentations. Reporting peaked in 2022 at $745 and has fallen 91.1% since, to $66 in 2025. That places this record below the midpoint for gastroenterology clinicians in TX, where the typical reported total is $3,104.
Across 34 payments — averaging $42.79 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Boston Scientific$325
- Madrigal Pharmaceuticals$175
- AstraZeneca$165
- Abbott$162
- Sanofi-aventis U.S. LLC$111
- ERBE USA Inc$90
- plus $426 from 12 others
What the payments were for
- Food & beverage$1,455100%
Most of this is food and beverage — typically meals provided during product presentations at a clinic or hospital. Nationally that is the single largest category of reported payments by count.
General payments by program year
Who reported the general payments
Companies are grouped under their corporate parent — a single manufacturer often files under several CMS reporting entities. Research and ownership payments are counted separately and are not in this table.
| Company | Payments | Total |
|---|---|---|
| Boston Scientific | 3 | $325 |
| Madrigal Pharmaceuticals | 4 | $175 |
| AstraZeneca | 3 | $165 |
| Abbott | 1 | $162 |
| Sanofi-aventis U.S. LLC | 1 | $111 |
| ERBE USA Inc | 1 | $90 |
| AbbVie | 2 | $58 |
| Bristol Myers Squibb | 3 | $49 |
| Johnson & Johnson | 2 | $43 |
| Daiichi Sankyo Inc. | 2 | $42 |
| Sanofi | 2 | $42 |
| Redhill Biopharma Inc. | 2 | $41 |
| QOL Medical, LLC | 2 | $37 |
| Gilead | 2 | $35 |
| Medtronic | 1 | $24 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 1 | $19 |
| Olympus America Inc. | 1 | $18 |
| Takeda Pharmaceuticals U.S.A., Inc. | 1 | $17 |
What the payments were tied to
Products named in the reported payments. Only payments of $100 or more are attributed here — the typical reported payment nationally is a meal worth about $16, and listing those product-by-product would be noise.
- Quadra Assura CRT Defibrillator$162
- GENERAL - THERAPIES$161
- ANDEXXA$125
- REZDIFFRA$121
- SPYSCOPE$116
How this compares
$1,455 in reported general payments places this provider in the 30th percentile of 1,350 gastroenterology providers in Texas.
Medicare billing
What this is not: this is the amount Original Medicare Part B allowed for services this provider billed in 2024. It is not their income. It excludes Medicare Advantage — now more than half of all Medicare enrollment — along with Medicaid and all commercial insurance, and it is gross practice revenue before staff, rent, supplies and malpractice premiums. CMS also suppresses any figure covering ten or fewer patients, so low-volume providers appear smaller than they are.
Other gastroenterology in Shenandoah
- Shail MaheshwariShenandoah$168K
- John FordtranDallas$9.9M
- Michael BrownDallas$5.5M
- Bincy AbrahamHouston$1.6M
- Mazen NoureddinHouston$1.5M
- Stephen PappasHouston$1.4M
- Anish PatelFort Sam Houston$1.3M
- Timothy RitterSouthlake$961K
- Parvez MantryDallas$958K
- Nadege GunnWaco$933K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Billing: Medicare Physician & Other Practitioners, data year 2024. Original Medicare Part B only.
- Identity: NPPES NPI Registry, July 2026.