Provider Demographics
NPI:1306141973
Name:ADEYEMI, OLAMIDE (CEO)
Entity type:Individual
Prefix:
First Name:OLAMIDE
Middle Name:
Last Name:ADEYEMI
Suffix:
Gender:M
Credentials:CEO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 AIRPORT FWY
Mailing Address - Street 2:SUITE 227
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-6129
Mailing Address - Country:US
Mailing Address - Phone:817-987-7863
Mailing Address - Fax:817-868-1042
Practice Address - Street 1:4101 AIRPORT FWY
Practice Address - Street 2:SUITE 227
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-6129
Practice Address - Country:US
Practice Address - Phone:817-987-7863
Practice Address - Fax:817-868-1042
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX146DOOOOOX3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport