Provider Demographics
NPI:1417036799
Name:GYENING, ISABELLA KWAATEMA (MD)
Entity Type:Individual
Prefix:
First Name:ISABELLA
Middle Name:KWAATEMA
Last Name:GYENING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-0000
Mailing Address - Fax:
Practice Address - Street 1:1200 MCKINNEY ST
Practice Address - Street 2:SUITE 473
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77010-2016
Practice Address - Country:US
Practice Address - Phone:713-442-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6984207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX124916108Medicaid
TX124916107Medicaid
TX386848YKTXMedicare PIN
TX124916103Medicaid
TX124916102Medicaid
TX81Y688Medicare PIN
TX124916103Medicaid
TX124916105Medicaid
TX124916102Medicaid
TX8293B7Medicare PIN
TX8A6706Medicare PIN