Provider Demographics
NPI:1972059426
Name:AJAYI, CHRIS (LVN)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:AJAYI
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11626 SEAGLERS POINT LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-3630
Mailing Address - Country:US
Mailing Address - Phone:346-702-3605
Mailing Address - Fax:346-223-0344
Practice Address - Street 1:11626 SEAGLERS POINT LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-3630
Practice Address - Country:US
Practice Address - Phone:832-758-8615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX325046164X00000X
372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No372600000XNursing Service Related ProvidersAdult Companion