Provider Demographics
NPI:1346734258
Name:BAYOUCITY PHYSICIANS PLLC
Entity Type:Organization
Organization Name:BAYOUCITY PHYSICIANS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ISMAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ADESANYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-547-8880
Mailing Address - Street 1:8727 W RAYFORD RD STE 160
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-5440
Mailing Address - Country:US
Mailing Address - Phone:281-547-8880
Mailing Address - Fax:772-264-0600
Practice Address - Street 1:8727 W RAYFORD RD STE 160
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-5440
Practice Address - Country:US
Practice Address - Phone:281-547-8880
Practice Address - Fax:772-264-0600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-15
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty