Individual provider Active NPI

Deborah Fadowole, M.D.

  • Emergency Medicine Physician
  • Pearland, TX
National Provider Identifier
1740501634
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
Q2661 Issued in TX
Practice address
11800 Astoria Blvd
Pearland, TX 77089-6041
Phone
(281) 929-6122
NPI assigned
Jun 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301096770 MI
Emergency Medicine Physician 207P00000X Q2661 TX Primary
Emergency Medicine Physician 207P00000X D0076009 MD

Addresses

Primary practice location

11800 Astoria Blvd
Pearland, TX 77089-6041

Mailing address

11800 Astoria Blvd
Houston, TX 77089-6041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150309000627 TX Practitioner - Emergency Medicine 3375787245 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Wisconsin School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hermann Hospital Based Physician GroupGroup PAC ID 4385075480, 272 clinicians

Practice addresses (Care Compare)

11800 Astoria Blvd
Houston, TX 77089-6041
Phone (713) 338-6565

Hospital & facility affiliations

  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301096770MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of TX, PLLC Emergency Medicine CurrentSince Jun 6, 2024 Accepting new patients
Memorial Hermann Hospital Based Physician Group Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine CurrentSince Feb 15, 2015 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

27800 NW Freeway
Cypress, TX 77433
Phone (346) 231-4000

225 E Parkwood Ave
Friendswood, TX 77546
Phone (281) 549-9400

921 Gessner Rd
Houston, TX 77024
Phone (713) 242-3439

7600 Fannin St
Houston, TX 77054
Phone (713) 791-7115

2555 Gulf Fwy S
League City, TX 77573
Phone (832) 932-9850

2555 Gulf Fwy S
#C1100
League City, TX 77573

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

11800 Astoria Blvd
Pearland, TX 77089
Phone (281) 929-6100

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

16100 South Fwy
Pearland, TX 77584
Phone (713) 413-5000

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

9250 Pinecroft Dr
#C
Shenandoah, TX 77380

26306 Kuykendahl Rd
Tomball, TX 77375
Phone (346) 246-7700

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1740501634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 ASTORIA BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770896041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 ASTORIA BLVD",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "770896041",
            "telephone_number": "281-929-6122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADOWOLE",
        "first_name": "DEBORAH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-15",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301096770",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q2661",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0076009",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

Verify at the official NPI Registry.