Individual
ADETAYO S MABADEJE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4000 SPENCER HWY, PASADENA, TX 77504-1202
(713) 359-2000
(713) 359-1004
Mailing address
PO BOX 3945, DEPT 841, HOUSTON, TX 77253-3945
(281) 358-8114
(281) 358-0609
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
M5824
TX
208VP0000X
Pain Medicine Physician
0101235560
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010034931
—
VA
01
—
1003493
VA PREMIER
VA
01
—
100988
ANTHEM
VA
05
—
1884389 01
—
TX
05
—
188438902
—
TX
05
—
188438903
—
TX
01
—
2224992
FIRST HEALTH
VA
01
—
230920
SOUTHERN HEALTH
VA
01
—
73866
OPTIMA
VA
01
—
7486021
CIGNA
VA
01
—
8AA961
BCSB
TX
01
—
8W7376
BLUE CROSS PROVIDER ID
TX
01
—
P00091266
PALMETTO
VA
01
—
P00416927
RAILROAD MEDICARE
TX
01
—
P00817171
RR MCR
TX
Enumeration date
02/07/2006
Last updated
01/13/2016
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