Provider Demographics
NPI:1740708957
Name:ADEDEJI ASSOCIATES PLLC
Entity type:Organization
Organization Name:ADEDEJI ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADEBUKOLA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ADEDEJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-339-2293
Mailing Address - Street 1:11212 STATE HWY 151
Mailing Address - Street 2:SUITE 200 MEDICAL PLAZA 1
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251
Mailing Address - Country:US
Mailing Address - Phone:210-339-2293
Mailing Address - Fax:844-427-8169
Practice Address - Street 1:11212 STATE HIGHWAY 151
Practice Address - Street 2:STE 200 MEDICAL PLAZA 1
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4504
Practice Address - Country:US
Practice Address - Phone:210-339-2293
Practice Address - Fax:844-427-8169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0719208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty