Provider Demographics
NPI:1578229621
Name:ADEYEMI, ADEBAYO SOLOMON
Entity Type:Individual
Prefix:
First Name:ADEBAYO
Middle Name:SOLOMON
Last Name:ADEYEMI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 WALNUT BEND LN # LANE228
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-4805
Mailing Address - Country:US
Mailing Address - Phone:210-774-6843
Mailing Address - Fax:
Practice Address - Street 1:3411 WALNUT BEND LN # LANE228
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-4805
Practice Address - Country:US
Practice Address - Phone:210-774-6843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)