Provider Demographics
NPI:1063412989
Name:OTUFALE, KAYODE ADELEKE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:KAYODE
Middle Name:ADELEKE
Last Name:OTUFALE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9727 MCKINNEY LN
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6344
Mailing Address - Country:US
Mailing Address - Phone:281-778-7466
Mailing Address - Fax:713-728-2230
Practice Address - Street 1:9727 MCKINNEY LN
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-6344
Practice Address - Country:US
Practice Address - Phone:281-778-7466
Practice Address - Fax:713-728-2230
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35536183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist