Individual provider Active NPI

Adewale Richard Adegboyega

  • Licensed Vocational Nurse
  • Cypress, TX
National Provider Identifier
1407344898
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
321756 Issued in TX
Practice address
13323 Via Torre de Pisa LN
Cypress, TX 77429-4768
Phone
(936) 714-4298
NPI assigned
May 1, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 321756 TX Primary

Addresses

Primary practice location

13323 Via Torre de Pisa LN
Cypress, TX 77429-4768

Mailing address

2801 Rolido Dr Apt 60
Houston, TX 77063-4325
Phone (832) 451-7945

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
321756TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1407344898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 ROLIDO DR APT 60",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770634325",
            "telephone_number": "832-451-7945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13323 VIA TORRE DE PISA LN",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774294768",
            "telephone_number": "936-714-4298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEGBOYEGA",
        "first_name": "ADEWALE",
        "middle_name": "RICHARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-01",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "321756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; 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.