Healthcare Provider Details

I. General information

NPI: 1043661382
Provider Name (Legal Business Name): ANDREW BADALAMENTI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2016
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BLOSSOM ST STE D
WEBSTER TX
77598-4200
US

IV. Provider business mailing address

450 BLOSSOM ST STE D
WEBSTER TX
77598-4200
US

V. Phone/Fax

Practice location:
  • Phone: 832-905-5940
  • Fax:
Mailing address:
  • Phone: 832-905-5940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4301110281
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberU6199
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: