Provider Demographics
NPI:1720546443
Name:KINGWOOD PULMONARY PA
Entity Type:Organization
Organization Name:KINGWOOD PULMONARY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AKINYINKA
Authorized Official - Middle Name:
Authorized Official - Last Name:AJELABI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-315-1454
Mailing Address - Street 1:201 KINGWOOD MEDICAL DR STE B100
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-6010
Mailing Address - Country:US
Mailing Address - Phone:713-315-1454
Mailing Address - Fax:832-644-9032
Practice Address - Street 1:201 KINGWOOD MEDICAL DR STE B100
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-6010
Practice Address - Country:US
Practice Address - Phone:713-315-1454
Practice Address - Fax:832-644-9032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty