Provider Demographics
NPI:1649729500
Name:AYORINDE, ABIMBOLA (MPH)
Entity type:Individual
Prefix:
First Name:ABIMBOLA
Middle Name:
Last Name:AYORINDE
Suffix:
Gender:F
Credentials:MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 N SAM HOUSTON PKWY E STE 205
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-3394
Mailing Address - Country:US
Mailing Address - Phone:404-542-7476
Mailing Address - Fax:
Practice Address - Street 1:340 N SAM HOUSTON PKWY E STE 205
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3394
Practice Address - Country:US
Practice Address - Phone:404-542-7476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-03
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management