Provider Demographics
NPI:1316370919
Name:ADELAKUN, KUDY DOLAPO
Entity Type:Individual
Prefix:MRS
First Name:KUDY
Middle Name:DOLAPO
Last Name:ADELAKUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6823 RIVER BLUFF DR.
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77085
Mailing Address - Country:US
Mailing Address - Phone:713-504-1436
Mailing Address - Fax:713-667-0712
Practice Address - Street 1:2626 SOUTH LOOP WEST #261
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054
Practice Address - Country:US
Practice Address - Phone:713-667-7202
Practice Address - Fax:713-667-0712
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX588394363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health