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NPI Code Detail

MEDICARE: ISABELLA KWAATEMA GYENING M.D.

MEDICARE: ISABELLA KWAATEMA GYENING M.D.
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
1207N00000XDermatology PhysicianJ6984TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417036799
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISABELLA KWAATEMA GYENING M.D.
Provider Business Mailing Address
First Line : 11511 SHADOW CREEK PKWY
Second Line :
City : PEARLAND
State : TX
Zip : 77584-7298
Country : US
Telephone Number : 713-442-0000
Fax Number :
Provider Business Practice Location Address
First Line : 1200 MCKINNEY ST
Second Line : SUITE 473
City : HOUSTON
State : TX
Zip : 77010-2016
Country : US
Telephone Number : 713-442-4700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2006
Last Update Date : 08/27/2021

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