Healthcare Provider Details

I. General information

NPI: 1134901432
Provider Name (Legal Business Name): VERONICA ADEOLA ADEYANJU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2023
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 BALCONES DR # 8940
AUSTIN TX
78731-4257
US

IV. Provider business mailing address

3820 PEARLWOOD RD
LITTLE ELM TX
75068-2478
US

V. Phone/Fax

Practice location:
  • Phone: 214-494-1549
  • Fax:
Mailing address:
  • Phone: 202-390-1753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1108819
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: