Provider Demographics
NPI:1831632975
Name:ALLIED DIGESTIVE DISEASE CENTER OF HOUSTON
Entity type:Organization
Organization Name:ALLIED DIGESTIVE DISEASE CENTER OF HOUSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BABATUNDE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEYEFA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-912-4481
Mailing Address - Street 1:21212 NORTHWEST FWY STE 425A
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-5884
Mailing Address - Country:US
Mailing Address - Phone:832-912-4481
Mailing Address - Fax:832-912-4464
Practice Address - Street 1:21212 NORTHWEST FWY STE 425A
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-5884
Practice Address - Country:US
Practice Address - Phone:832-912-4481
Practice Address - Fax:832-912-4464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5253261QM2500X
207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty