MEDICARE: DR. ADENIRAN ABRAHAM ARIYO MD

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	174400000X	Specialist	L4224	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0030JQ	OTHER	TX	BCBS ID NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578510921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADENIRAN ABRAHAM ARIYO MD

Provider Business Mailing Address
First Line	:	PO BOX 192591
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-8523
Country	:	US
Telephone Number	:	972-962-2498
Fax Number	:	972-287-7807

Provider Business Practice Location Address
First Line	:	3535 W WHEATLAND RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75237-3461
Country	:	US
Telephone Number	:	972-223-0550
Fax Number	:	972-223-0551

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

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	01/18/2023

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