Healthcare Provider Details

I. General information

NPI: 1073402392
Provider Name (Legal Business Name): HANNAH GBADEBO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 RIVERWOOD CT STE 115
CONROE TX
77304-2974
US

IV. Provider business mailing address

1020 RIVERWOOD CT STE 115
CONROE TX
77304-2974
US

V. Phone/Fax

Practice location:
  • Phone: 936-788-2212
  • Fax:
Mailing address:
  • Phone: 936-788-2212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number81903
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: