Olamide Adeyemi, C.E.O
Individual provider Active NPI Land Ambulance · Bedford, TX
NPI 1306141973 · NPPES record last updated Jan 12, 2011
Key facts
- NPI
- 1306141973
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 146DOOOOOX (TX)
- Practice address
- 4101 Airport Fwy
Suite 227
Bedford, TX 76021-6129 - Phone
- (817) 987-7863
- Fax
- (817) 868-1042
- NPI assigned
- Jan 12, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146DOOOOOX | TX | MD | Land Ambulance |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crystal Mas International | Land Transport | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 146DOOOOOX | TX | Yes |
Addresses
Primary practice location
4101 Airport Fwy
Suite 227
Bedford, TX 76021-6129
Mailing address
4101 Airport Fwy
Suite 227
Bedford, TX 76021-6129
Phone (817) 987-7863
Other providers in Bedford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.