Provider Demographics
NPI:1225848047
Name:AIYEJUTO, FEMI M
Entity type:Individual
Prefix:MR
First Name:FEMI
Middle Name:M
Last Name:AIYEJUTO
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 1:1701 GATEWAY BLVD STE 447
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3627
Mailing Address - Country:US
Mailing Address - Phone:469-778-0099
Mailing Address - Fax:469-778-0109
Practice Address - Street 1:1701 GATEWAY BLVD STE 447
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3627
Practice Address - Country:US
Practice Address - Phone:469-778-0099
Practice Address - Fax:469-778-0109
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX739621163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse