Provider Demographics
NPI:1871687244
Name:BATES, JANEEN GABALDON (MD)
Entity type:Individual
Prefix:
First Name:JANEEN
Middle Name:GABALDON
Last Name:BATES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANEEN
Other - Middle Name:
Other - Last Name:GABALDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 737460
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-7460
Mailing Address - Country:US
Mailing Address - Phone:713-338-4523
Mailing Address - Fax:
Practice Address - Street 1:3203 BROADWAY ST STE 100
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-1415
Practice Address - Country:US
Practice Address - Phone:281-485-8876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9838207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX217174605Medicaid
TX217174606Medicaid
NM97588369Medicaid
TX217174607Medicaid
TX373674YKTVMedicare PIN
TX217174605Medicaid
NM97588369Medicaid
TX217174607Medicaid
I46608Medicare UPIN