Provider Demographics
NPI:1649421934
Name:ADEYEKUN, OMOBOLANLE OMOLAYO (MD)
Entity type:Individual
Prefix:DR
First Name:OMOBOLANLE
Middle Name:OMOLAYO
Last Name:ADEYEKUN
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:OMOBOLANLE
Other - Middle Name:OMOLAYO
Other - Last Name:ONIBONOJE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10603 BELSHILL ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2116
Mailing Address - Country:US
Mailing Address - Phone:516-941-6230
Mailing Address - Fax:
Practice Address - Street 1:18220 TOMBALL PKWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4347
Practice Address - Country:US
Practice Address - Phone:281-737-0587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-04
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010021661207R00000X
TXP5152208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1649421934Medicaid
MO148160019Medicare PIN