Adesola Olatunji Fadeyi, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

9197 Issued in TX

Practice address

1169 N Burleson Blvd Ste 121
Burleson, TX 76028-7011

Phone

(817) 426-6060

Fax

(817) 426-2978

NPI assigned

May 24, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Prime Vision Center PLLC

  • Optometrist
  • Fort Worth, TX
  • NPI 1649151523
  Medicare reassignment NPD Authorized official
• Med Southwest, PLLC

  • Optometrist
  • Houston, TX
  • NPI 1609348739
  Medicare reassignment NPD
• Med Southwest, PLLC

  • Optometrist
  • Greenville, TX
  • NPI 1649800558
  NPD
• Med Southwest, PLLC

  • Optometrist
  • Oklahoma City, OK
  • NPI 1679440762
  NPD

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1477081271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 N BURLESON BLVD STE 121",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287011",
            "telephone_number": "817-426-6060",
            "fax_number": "817-426-2978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADEYI",
        "first_name": "ADESOLA",
        "middle_name": "OLATUNJI",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-24",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eye Feel Pretty PLLC
• Eyemasters of Texas LTD
• F&R Healthcare Services Inc
• F&R Healthcare Services Inc
• Jeffrey Anthony Fabiano
• Family Smiles
• Justin Kyle Fancher, PHARM.D
• Sherry Lynn Fancher, LPC
• Kimberly Farias, DO
• Olalekan Fasonu

• Optometrist in Burleson, TX
• Providers in Burleson, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.