Provider Demographics
NPI:1629437405
Name:AKINTONDE, ADEOLA
Entity Type:Individual
Prefix:
First Name:ADEOLA
Middle Name:
Last Name:AKINTONDE
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 1:1910 WESTMEAD DR
Mailing Address - Street 2:SUITE 3402
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-4756
Mailing Address - Country:US
Mailing Address - Phone:832-614-1608
Mailing Address - Fax:281-741-5811
Practice Address - Street 1:1910 WESTMEAD DR
Practice Address - Street 2:SUITE 3402
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-4756
Practice Address - Country:US
Practice Address - Phone:832-614-1608
Practice Address - Fax:281-741-5811
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81-1512629343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)