Healthcare Provider Details

I. General information

NPI: 1275813362
Provider Name (Legal Business Name): EMMANUEL ADJEI-GYAMFI PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2011
Last Update Date: 04/21/2022
Certification Date: 04/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 TAUB LOOP
HOUSTON TX
77030-1608
US

IV. Provider business mailing address

1504 TAUB LOOP, 1EC, BCM285 DEPT OF EMERGENCY MEDICINE
HOUSTON TX
77030
US

V. Phone/Fax

Practice location:
  • Phone: 713-798-1750
  • Fax: 713-798-4693
Mailing address:
  • Phone: 713-873-3565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberAP13953
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number015005
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberAP13953
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: