Provider Demographics
NPI:1700014628
Name:ADEYEFA, OLUDAYO ADEDOTUN (MD)
Entity Type:Individual
Prefix:DR
First Name:OLUDAYO
Middle Name:ADEDOTUN
Last Name:ADEYEFA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3856
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77253-3856
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7010 CHAMPIONS PLAZA DR STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-2394
Practice Address - Country:US
Practice Address - Phone:832-698-7725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5583207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01264933OtherRAILROAD MEDICARE
TX8DW510OtherBCBS
TX324719901Medicaid
TXP01264933OtherRAILROAD MEDICARE