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NPI Code Detail

MEDICARE: ADETOUN OMOLOLA ARIYIBI RN

MEDICARE: ADETOUN OMOLOLA ARIYIBI RN
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
1163W00000XRegistered Nurse847356TX

General Provider Information

NPI Number : 1639650856
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADETOUN OMOLOLA ARIYIBI RN
Provider Business Mailing Address
First Line : 5507 QUARRY RIDGE RD
Second Line :
City : RICHMOND
State : TX
Zip : 77407-4152
Country : US
Telephone Number : 713-884-9596
Fax Number :
Provider Business Practice Location Address
First Line : 16320 MELLOW OAKS LN
Second Line :
City : SUGAR LAND
State : TX
Zip : 77498-7214
Country : US
Telephone Number : 713-702-6240
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2018
Last Update Date : 08/25/2018

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