MEDICARE: DR. ASHISH N. DEBROY 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	208000000X	Pediatrics Physician	N7789	TX
2	2080P0206X	Pediatric Gastroenterology Physician	N7789	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	:	1215146345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHISH N. DEBROY MD

Provider Business Mailing Address
First Line	:	2700 CULLEN BLVD UNIT 842247
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-1989
Country	:	US
Telephone Number	:	832-285-2938
Fax Number	:

Provider Business Practice Location Address
First Line	:	2045 SPACE PARK DR STE 280
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-6311
Country	:	US
Telephone Number	:	832-205-8215
Fax Number	:

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

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	07/11/2024

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