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General NPI Number Information
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NPI Number | 1942395710
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Entity Type | Organization
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Legal Business Name | PAIN CONSULT SERVICES OF TEXAS PA
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 12/10/2008
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Provider Practice Location Address
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Address Line | 6411 FANNIN ST 3RD FLOOR ROBERTSON PAVILION
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City | HOUSTON
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State | TX
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Zip | 77030-1501
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Country | US
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Telephone | 713-704-2732
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Fax | 713-704-5711
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Provider Business Mailing Address
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Address Line | PO BOX 20508
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City | HOUSTON
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State | TX
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Zip | 77225-0508
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GBADEBO J. ADEBAYO
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Credential | M.D.
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Telephone | 623-533-5335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | K1330
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License Number State | TX
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