Provider Demographics
NPI:1285809251
Name:IGUN, ADENIYI OLAWALE (MD)
Entity type:Individual
Prefix:
First Name:ADENIYI
Middle Name:OLAWALE
Last Name:IGUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11345 ALAMO RANCH PKWY
Mailing Address - Street 2:STE. 202
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-6440
Mailing Address - Country:US
Mailing Address - Phone:210-688-9190
Mailing Address - Fax:855-744-6297
Practice Address - Street 1:11345 ALAMO RANCH PKWY
Practice Address - Street 2:STE. 202
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-6440
Practice Address - Country:US
Practice Address - Phone:210-688-9190
Practice Address - Fax:877-936-8202
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXFI3546883207R00000X
TXP3733207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine