MEDICARE: DR. ADRIAN GRESORES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080N0001X	Neonatal-Perinatal Medicine Physician	H8088	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144278516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADRIAN GRESORES MD

Provider Business Mailing Address
First Line	:	6620 CYPRESSWOOD DR STE 200
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-7748
Country	:	US
Telephone Number	:	281-477-8660
Fax Number	:	281-477-8662

Provider Business Practice Location Address
First Line	:	6620 CYPRESSWOOD DR STE 200
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-7748
Country	:	US
Telephone Number	:	281-477-8660
Fax Number	:	281-477-8662

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	12/06/2015

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