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NPI Code Detail

MEDICARE: ADE ADEDUNTAN

MEDICARE: ADE ADEDUNTAN
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
1302R00000XHealth Maintenance Organization2019839TX
2305R00000XPreferred Provider Organization2019839TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
117669182OTHERTXNPN

General Provider Information

NPI Number : 1780056002
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADE ADEDUNTAN
Provider Business Mailing Address
First Line : 16103 APRIL RIDGE DR
Second Line :
City : HOUSTON
State : TX
Zip : 77083
Country : US
Telephone Number : 832-818-1754
Fax Number :
Provider Business Practice Location Address
First Line : 16103 APRIL RIDGE DR
Second Line :
City : HOUSTON
State : TX
Zip : 77083-5255
Country : US
Telephone Number : 832-818-1754
Fax Number :
Authorized Official
Title or Position : AGENT
Name : MR. ADEWUMI ADEDUNTAN
Credential :
Telephone Number : 832-818-1754
Provider Enumeration Date : 10/26/2015
Last Update Date : 10/26/2015

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Directions to “ADE ADEDUNTAN ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.