Individual provider Active NPI

Olajumoke Idayat Idris, MD

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1346982477
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
V8650 Issued in TX
Practice address
4755 Aldine Mail Route Rd
Houston, TX 77039-5934
Phone
(281) 985-7600
NPI assigned
Apr 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X V8650 TX Primary

Addresses

Primary practice location

4755 Aldine Mail Route Rd
Houston, TX 77039-5934

Mailing address

4755 Aldine Mail Route Rd
Houston, TX 77039-5934
Phone (281) 985-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250826001026 TX Practitioner - Family Practice 3476053257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Howard University College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

4755 Aldine Mail Route Rd
Houston, TX 77039-5934
Phone (281) 985-7600

4755 Aldine Mail Rte
Houston, TX 77039-5934
Phone (281) 985-7617

6410 Fannin St
Houston, TX 77030-3005

Hospital & facility affiliations

  • Harris Health Hospital, Houston, TX, CCN 450289

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
V8650TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Aug 1, 2025 Accepting new patients
Ut Physicians Family Medicine CurrentSince Aug 1, 2025 Accepting new patients

Locations

4755 Aldine Mail Rte
Houston, TX 77039
Phone (281) 985-7600

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6410 Fannin St
#135
Houston, TX 77030

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1649462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1346982477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4755 ALDINE MAIL ROUTE RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770395934",
            "telephone_number": "281-985-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 ALDINE MAIL ROUTE RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770395934",
            "telephone_number": "281-985-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDRIS",
        "first_name": "OLAJUMOKE",
        "middle_name": "IDAYAT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-09",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "V8650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.