Provider Demographics
NPI:1487086427
Name:G.A.DEBAKEY M.D. P.A.
Entity type:Organization
Organization Name:G.A.DEBAKEY M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:DEBAKEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-351-1195
Mailing Address - Street 1:11609 SPRING CYPRESS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-8917
Mailing Address - Country:US
Mailing Address - Phone:281-351-1195
Mailing Address - Fax:281-351-0519
Practice Address - Street 1:11609 SPRING CYPRESS RD
Practice Address - Street 2:SUITE A
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-8917
Practice Address - Country:US
Practice Address - Phone:281-351-1195
Practice Address - Fax:281-351-0519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3282207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0030YKOtherBLUE CROSS BLUE SHIELD
TX149150801Medicaid
TXDB377OtherRAILROAD MEDICARE
TX149150801Medicaid