Provider Demographics
NPI:1043248156
Name:DARDEN, ADEOLA B (MD)
Entity type:Individual
Prefix:
First Name:ADEOLA
Middle Name:B
Last Name:DARDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ADEOLA
Other - Middle Name:B
Other - Last Name:AKINOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7979 W VIRGINIA DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3798
Mailing Address - Country:US
Mailing Address - Phone:214-884-4700
Mailing Address - Fax:972-656-0380
Practice Address - Street 1:7979 W VIRGINIA DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3798
Practice Address - Country:US
Practice Address - Phone:214-884-4700
Practice Address - Fax:972-656-0380
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5526207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX281150708Medicaid
TX275206YKQJMedicare PIN