Modupeola Adedeji

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MODUPEOLA ADEDEJI

Practice address

530 San Pedro Ave
San Antonio, TX 78212-5006

Phone

(210) 697-5700

Fax

(210) 558-9032

NPI assigned

Oct 11, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Adediran Adedeji

Title

Ceo

Phone

(210) 697-5700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• La Paz Community Health Care Center, Inc. Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215388800000",
    "number": "1336137678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 SAN PEDRO AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125006",
            "telephone_number": "210-697-5700",
            "fax_number": "210-558-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 SAN PEDRO AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125006",
            "telephone_number": "210-697-5700",
            "fax_number": "210-558-9032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODUPEOLA ADEDEJI",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2008-07-07",
        "status": "A",
        "authorized_official_last_name": "ADEDEJI",
        "authorized_official_first_name": "ADEDIRAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "210-697-5700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021375301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Paz Community Health Care Center, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Modern Optometry PLLC
• Lana Moderow
• Leeann R Modgling, PHARMD
• Joshua Allan Modica, ATC, LAT
• Modk Monitoring PLLC
• Modupeola Olajumoke Adedeji (La Paz Community Health Center)
• Priti Mody-Bailey, M.D.
• Roderick Donald Moe Jr., MD
• Ashley Moeckel, LPC
• Sarah Glenn Moehrig, LPA

• Mental Health Clinic/Center (Including Community Mental Health Center) in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.