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General NPI Number Information
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NPI Number | 1952941973
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Entity Type | Individual
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Provider Name | AYOWOLE ADEOTI MS. LCDC
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Gender | Male
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 11/13/2020
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Provider Practice Location Address
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Address Line | 7457 HARWIN DR STE 303H
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City | HOUSTON
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State | TX
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Zip | 77036-2027
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Country | US
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Telephone | 832-649-8038
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Fax | 832-831-1655
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Provider Business Mailing Address
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Address Line | 7457 HARWIN DR STE 303H
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City | HOUSTON
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State | TX
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Zip | 77036-2027
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Country | US
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Telephone | 832-649-3083
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Fax | 832-831-1655
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 4265
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License Number State | TX
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