1841447992 NPI number — DR. OLUMAYOWA ADEFUNKE ADERINTO M.D

Table of content: DR. OLUMAYOWA ADEFUNKE ADERINTO M.D (NPI 1841447992)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841447992 NPI number — DR. OLUMAYOWA ADEFUNKE ADERINTO M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADERINTO
Provider First Name:
OLUMAYOWA
Provider Middle Name:
ADEFUNKE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ADEEKUN
Provider Other First Name:
MAYOWA
Provider Other Middle Name:
ADEFUNKE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841447992
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/22/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4502 RIVERSTONE BLVD
Provider Second Line Business Mailing Address:
STE 1403
Provider Business Mailing Address City Name:
MISSOURI CITY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77459-5210
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-239-4249
Provider Business Mailing Address Fax Number:
281-978-4341

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 ST. JOSEPH PARKWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77002-8301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-756-8537
Provider Business Practice Location Address Fax Number:
713-756-8538
Provider Enumeration Date:
08/20/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  46518 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: N8749 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)