Provider Demographics
NPI:1114123999
Name:AYO A AJIM
Entity Type:Organization
Organization Name:AYO A AJIM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AYO
Authorized Official - Middle Name:A
Authorized Official - Last Name:AJIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-951-0000
Mailing Address - Street 1:2000 CRAWFORD ST
Mailing Address - Street 2:SUITE 730
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-9000
Mailing Address - Country:US
Mailing Address - Phone:713-951-0000
Mailing Address - Fax:713-951-0001
Practice Address - Street 1:2000 CRAWFORD ST
Practice Address - Street 2:SUITE 730
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-9000
Practice Address - Country:US
Practice Address - Phone:713-951-0000
Practice Address - Fax:713-951-0001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID
TX00197HMedicare ID - Type UnspecifiedMEDICARE