Provider Demographics
NPI:1265876031
Name:AYENI, OLUSIMIDELE TOLULOPE (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:OLUSIMIDELE
Middle Name:TOLULOPE
Last Name:AYENI
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6326 GRAND PROMINENCE CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7685
Mailing Address - Country:US
Mailing Address - Phone:240-338-7521
Mailing Address - Fax:
Practice Address - Street 1:705 S FRY RD STE 120
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2252
Practice Address - Country:US
Practice Address - Phone:281-398-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ8205208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics