Provider Demographics
NPI:1063166809
Name:AJAYI-ADEDIRAN, STELLA (NP)
Entity type:Individual
Prefix:
First Name:STELLA
Middle Name:
Last Name:AJAYI-ADEDIRAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7615 AIMUA CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-3741
Mailing Address - Country:US
Mailing Address - Phone:713-303-5698
Mailing Address - Fax:
Practice Address - Street 1:15500 VOSS RD STE 1059
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-4601
Practice Address - Country:US
Practice Address - Phone:832-377-5758
Practice Address - Fax:713-583-8857
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1070382363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health