Organization
ADE ADEDUNTAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADEWUMI ADEDUNTAN (AGENT)
(832) 818-1754
Entity
Organization
Contact information
Practice address
16103 APRIL RIDGE DR, HOUSTON, TX 77083-5255
(832) 818-1754
Mailing address
16103 APRIL RIDGE DR, HOUSTON, TX 77083
(832) 818-1754
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
2019839
TX
305R00000X
Preferred Provider Organization
Primary
2019839
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17669182
NPN
TX
Enumeration date
10/26/2015
Last updated
10/26/2015
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