Healthcare Provider Details

I. General information

NPI: 1962145656
Provider Name (Legal Business Name): ABDOUL MADJID KONE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2022
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 E MEDICAL CENTER BLVD # 100
WEBSTER TX
77598-4376
US

IV. Provider business mailing address

205 E MEDICAL CENTER BLVD # 100
WEBSTER TX
77598-4376
US

V. Phone/Fax

Practice location:
  • Phone: 646-510-7690
  • Fax:
Mailing address:
  • Phone: 646-510-7690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2025029205
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberV3355
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2025029205
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: