Adisa A Tijani

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0066978 Issued in TX

Practice address

9319 LBJ Fwy
Ste 208G
Dallas, TX 75243-3450

Phone

(214) 575-0666

NPI assigned

Feb 13, 2008

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

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202860800000",
    "number": "1700054665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741411",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753741411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9319 LBJ FWY",
            "address_2": "STE 208G",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433450",
            "telephone_number": "214-575-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIJANI",
        "first_name": "ADISA",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0066978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173760303",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173760301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "531586",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1628794",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173760302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Tift, CRNA
• Kristen Tignall, CRNA
• Delphine Tih, CRNA
• Monika Tiido, AU.D.
• Keely Tiiman
• Alexandria Tijerina, RN
• Ethel-Sonia Tikum, APRN, NP-C
• Rebecca Tilden, MCN, RD, LD
• Mark A Till, MD
• Jason Tiller

• Durable Medical Equipment & Medical Supplies in Dallas, TX
• Providers in Dallas, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.