Provider Demographics
NPI:1538770011
Name:OLAYEMI, TAIYE OLANIYI (SOLE PROPRIETOR)
Entity type:Individual
Prefix:MR
First Name:TAIYE
Middle Name:OLANIYI
Last Name:OLAYEMI
Suffix:
Gender:M
Credentials:SOLE PROPRIETOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16315 YABBIE DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-7631
Mailing Address - Country:US
Mailing Address - Phone:414-391-3527
Mailing Address - Fax:
Practice Address - Street 1:16315 YABBIE DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-7631
Practice Address - Country:US
Practice Address - Phone:414-391-3527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLKM1819343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)