Provider Demographics
NPI:1811669716
Name:OLADIMEJI, FELIX
Entity type:Individual
Prefix:
First Name:FELIX
Middle Name:
Last Name:OLADIMEJI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12710 BRANT ROCK DR APT 314
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-5433
Mailing Address - Country:US
Mailing Address - Phone:346-218-4484
Mailing Address - Fax:
Practice Address - Street 1:12710 BRANT ROCK DR APT 314
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-5433
Practice Address - Country:US
Practice Address - Phone:346-218-4484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-29
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR280470343900000X
343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR280470OtherBUSINESS LICENCE