MEDICARE: JOHN Q ADAMS MD PA INC

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	207L00000X	Anesthesiology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC7117	OTHER	TX	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1215911037
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN Q ADAMS MD PA INC

Provider Business Mailing Address
First Line	:	PO BOX 421209
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77242-1209
Country	:	US
Telephone Number	:	713-481-3534
Fax Number	:	713-432-0221

Provider Business Practice Location Address
First Line	:	10918 EAST FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77029-1912
Country	:	US
Telephone Number	:	713-481-3534
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOHN Q. ADAMS
Credential	:	M.D.
Telephone Number	:	713-481-3534

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	03/20/2009

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