Provider Demographics
NPI:1740405018
Name:RONNIE L ADAMS MD PA
Entity type:Organization
Organization Name:RONNIE L ADAMS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:LASALLE
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:713-802-9694
Mailing Address - Street 1:1740 WEST 27TH STREET
Mailing Address - Street 2:SUITE 321
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008
Mailing Address - Country:US
Mailing Address - Phone:713-802-9694
Mailing Address - Fax:713-802-9961
Practice Address - Street 1:1740 WEST 27TH STREET
Practice Address - Street 2:SUITE 321
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008
Practice Address - Country:US
Practice Address - Phone:713-802-9694
Practice Address - Fax:713-802-9961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM3839OtherMEDICAL LICENSE
TX166293Medicare UPIN