Provider Demographics
NPI:1588281596
Name:ADEEKO, DOREEN OLAYEMI (NP)
Entity type:Individual
Prefix:MRS
First Name:DOREEN
Middle Name:OLAYEMI
Last Name:ADEEKO
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 GOODNIGHT LN
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-1512
Mailing Address - Country:US
Mailing Address - Phone:214-223-4746
Mailing Address - Fax:
Practice Address - Street 1:5702 LAVON DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-3126
Practice Address - Country:US
Practice Address - Phone:972-495-5595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141328363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1588281596Medicaid