Provider Demographics
NPI:1659047785
Name:AKINTADE, OMOJOLAADE DOYINSOLA (MD, MSCR)
Entity type:Individual
Prefix:DR
First Name:OMOJOLAADE
Middle Name:DOYINSOLA
Last Name:AKINTADE
Suffix:
Gender:
Credentials:MD, MSCR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3551 ROGER BROOKE DR
Mailing Address - Street 2:
Mailing Address - City:JBSA FT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4504
Mailing Address - Country:US
Mailing Address - Phone:210-292-3410
Mailing Address - Fax:210-292-7868
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:
Practice Address - City:JBSA FT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-292-3410
Practice Address - Fax:210-292-7868
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider