Provider Demographics
NPI:1922779677
Name:ADENIRAN, OYEYEMI O (NP)
Entity Type:Individual
Prefix:
First Name:OYEYEMI
Middle Name:O
Last Name:ADENIRAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 N GATE DR
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-2378
Mailing Address - Country:US
Mailing Address - Phone:214-980-1920
Mailing Address - Fax:214-980-1686
Practice Address - Street 1:20 N GATE DR
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-2378
Practice Address - Country:US
Practice Address - Phone:214-980-1920
Practice Address - Fax:214-980-1686
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1036743363LF0000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily