MEDICARE: MR. TAIYE OLANIYI OLAYEMI SOLE PROPRIETOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	LKM1819	TX

General Provider Information

NPI Number	:	1538770011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TAIYE OLANIYI OLAYEMI SOLE PROPRIETOR

Provider Business Mailing Address
First Line	:	21711 RESERVE RANCH TRL
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-3624
Country	:	US
Telephone Number	:	414-391-3527
Fax Number	:

Provider Business Practice Location Address
First Line	:	21711 RESERVE RANCH TRL
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-3624
Country	:	US
Telephone Number	:	414-391-3527
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2020
Last Update Date	:	03/02/2026

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