Basic Information
Provider Information | |||||||||
NPI: | 1154680973 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | AKINTOLA | ||||||||
FirstName: | MORAKINYO | ||||||||
MiddleName: | OLANREWAJU | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 7145 READING RD | ||||||||
Address2: | APT 2008 | ||||||||
City: | ROSENBERG | ||||||||
State: | TX | ||||||||
PostalCode: | 774716330 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: |   | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 23900 KATY FWY | ||||||||
Address2: | EMERGENCY DEPARTMENT | ||||||||
City: | KATY | ||||||||
State: | TX | ||||||||
PostalCode: | 774941323 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2816447000 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/14/2012 | ||||||||
LastUpdateDate: | 08/01/2016 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 0101257621 | VA | N |   | Allopathic & Osteopathic Physicians | Emergency Medicine |   | 207P00000X | Q7997 | TX | Y |   | Allopathic & Osteopathic Physicians | Emergency Medicine |   |
No ID Information.