Provider Demographics
NPI:1194429308
Name:ONIPEDE, SURAJUDEEN AYO
Entity type:Individual
Prefix:
First Name:SURAJUDEEN
Middle Name:AYO
Last Name:ONIPEDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9955 CLUB CREEK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-7583
Mailing Address - Country:US
Mailing Address - Phone:713-550-4933
Mailing Address - Fax:
Practice Address - Street 1:9955 CLUB CREEK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7583
Practice Address - Country:US
Practice Address - Phone:713-550-4933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider