Provider Demographics
NPI:1538486444
Name:ADEBO, SENAIT MENGISTEAB (MD)
Entity Type:Individual
Prefix:DR
First Name:SENAIT
Middle Name:MENGISTEAB
Last Name:ADEBO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SENAIT
Other - Middle Name:MENGISTEAB
Other - Last Name:GEBREMESKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4502 RIVERSTONE BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-5213
Mailing Address - Country:US
Mailing Address - Phone:832-581-7474
Mailing Address - Fax:
Practice Address - Street 1:4502 RIVERSTONE BLVD STE 204
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-5213
Practice Address - Country:US
Practice Address - Phone:832-581-7474
Practice Address - Fax:832-384-9459
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-01
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4464302080A0000X
390200000X
TXP8829208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program