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General NPI Number Information
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NPI Number | 1023122371
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Entity Type | Individual
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Provider Name | SAMUEL A ADESOBA MD
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 09/19/2019
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Provider Practice Location Address
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Address Line | 9639 FONDREN ROAD
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City | HOUSTON
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State | TX
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Zip | 77096
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Country | US
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Telephone | 713-962-4055
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Fax | 713-962-4055
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Provider Business Mailing Address
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Address Line | P.O. BOX 711047
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City | HOUSTON
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State | TX
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Zip | 77271
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Country | US
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Telephone | 713-962-4055
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Fax | 713-962-4055
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | K7235
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | K7235
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | K7235
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License Number State | TX
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