Olayiwola Adebisi, PTA – Rehabilitation Clinic/Center

Key facts

NPI: 1396409207
Entity type: Individual (NPI type 1)
Primary specialty: Rehabilitation Clinic/Center 261QR0400X
Practice address: 9777 W Gulf Bank Rd Ste 10
Houston, TX 77040-3137
Phone: (713) 849-6603
NPI assigned: Oct 26, 2021
Sex: Male
Sole proprietor: Yes

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.

Hopemedic Physical Therapy, LLC Physical Therapist · Sugar Land, TX · NPI 1710644588

NPD Authorized official
Educare Community Living Corporation Texas Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Houston, TX · NPI 1093578502

NPD

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Educare Community Living Corporation Texas		Current since Feb 11, 2024	Accepting new patients
Hopemedic Physical Therapy, LLC		Current since Dec 5, 2021	Accepting new patients

Locations

9777 W Gulf Bank Rd
Ste 10
Houston, TX 77040
Phone (713) 849-6603

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Rehabilitation Clinic/Center	261QR0400X			Yes

Addresses

Primary practice location

9777 W Gulf Bank Rd Ste 10
Houston, TX 77040-3137

Mailing address

14819 Horse Creek LN
Sugar Land, TX 77498-7059
Phone (832) 532-0668

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 27, 2021.

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1396409207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14819 HORSE CREEK LN",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774987059",
            "telephone_number": "832-532-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9777 W GULF BANK RD STE 10",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770403137",
            "telephone_number": "713-849-6603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEBISI",
        "first_name": "OLAYIWOLA",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

All providers in Houston, TX · Rehabilitation Clinic/Center in Texas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2021. 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.

Verify at the official NPI Registry.