Provider Demographics
NPI:1871061184
Name:ADENIRAN, ADEBISI WURAOLA
Entity type:Individual
Prefix:MR
First Name:ADEBISI
Middle Name:WURAOLA
Last Name:ADENIRAN
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 1:14601 BELLAIRE BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-2505
Mailing Address - Country:US
Mailing Address - Phone:832-731-7714
Mailing Address - Fax:
Practice Address - Street 1:16227 CYPRESS TRACE DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1679
Practice Address - Country:US
Practice Address - Phone:832-731-7714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle