Olawale Ayodele
Individual provider Active NPI Driver · League City, TX
NPI 1750161675 · NPPES record last updated Sep 29, 2023
Key facts
- NPI
- 1750161675
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- 39799226 (TX)
- Practice address
- 1751 W Walker St Apt 10101
League City, TX 77573-4299 - Phone
- (936) 777-5622
- NPI assigned
- Sep 29, 2023
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39799226 | TX | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 39799226 | TX | Yes |
Addresses
Primary practice location
1751 W Walker St Apt 10101
League City, TX 77573-4299
Mailing address
607 E Abram St Ste 14
Arlington, TX 76010-1206
Phone (817) 903-3353
Other providers in League City, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2023. 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.