Provider Demographics
NPI:1700378353
Name:ADESANYA, MISTURAT (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:MISTURAT
Middle Name:
Last Name:ADESANYA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:OLA
Other - Middle Name:
Other - Last Name:ADESANYA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:8727 W RAYFORD DR
Mailing Address - Street 2:160
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389
Mailing Address - Country:US
Mailing Address - Phone:281-547-8880
Mailing Address - Fax:
Practice Address - Street 1:8727 W RAYFORD DR
Practice Address - Street 2:160
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389
Practice Address - Country:US
Practice Address - Phone:281-547-8880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363LF0000X
TXAP137825207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty