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NPI Code Detail

MEDICARE: GARY ALAN DEBAKEY M.D.

MEDICARE: GARY ALAN DEBAKEY 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
1208VP0000XPain Medicine PhysicianG3282TX
2207VG0400XGynecology PhysicianG3282TX

Other Identifiers

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

General Provider Information

NPI Number : 1770663254
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY ALAN DEBAKEY M.D.
Provider Business Mailing Address
First Line : 17376 NORTHWEST FWY
Second Line :
City : JERSEY VILLAGE
State : TX
Zip : 77040-1114
Country : US
Telephone Number : 329-198-4458
Fax Number : 329-198-4468
Provider Business Practice Location Address
First Line : 17376 NORTHWEST FWY
Second Line :
City : JERSEY VILLAGE
State : TX
Zip : 77040-1114
Country : US
Telephone Number : 832-919-8445
Fax Number : 832-919-8446
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2006
Last Update Date : 06/28/2021

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