Provider Demographics
NPI:1346128022
Name:KISOMOSE, ADAMS MAJOBA
Entity type:Individual
Prefix:
First Name:ADAMS
Middle Name:MAJOBA
Last Name:KISOMOSE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7611 SUNSET RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-2699
Mailing Address - Country:US
Mailing Address - Phone:346-762-3203
Mailing Address - Fax:
Practice Address - Street 1:7611 SUNSET RIDGE LN
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441-2699
Practice Address - Country:US
Practice Address - Phone:346-762-3203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32101413519343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)