Provider Demographics
NPI:1700078706
Name:ADENIYI, MUNIRU O (MD)
Entity Type:Individual
Prefix:
First Name:MUNIRU
Middle Name:O
Last Name:ADENIYI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18220 STATE HIGHWAY 249 STE 490
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4347
Mailing Address - Country:US
Mailing Address - Phone:281-737-0587
Mailing Address - Fax:
Practice Address - Street 1:3003 S LOOP W STE 204
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1371
Practice Address - Country:US
Practice Address - Phone:713-796-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZN0300XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherNephrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX212160005Medicaid
TX2121600-09Medicaid
TX212160006Medicaid
TX212160005Medicaid
TXTXB129609Medicare PIN
TX2121600-09Medicaid
TXP00940997Medicare PIN
TXTXB134439Medicare PIN