Basic Information
| Provider Information | |||||||||
| NPI: | 1700021193 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADIO | ||||||||
| FirstName: | TITILOLA | ||||||||
| MiddleName: | ROSEMARIE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ADIO-ODUOLA | ||||||||
| OtherFirstName: | TITILOLA | ||||||||
| OtherMiddleName: | ROSEMARIE | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 6620 MAIN STREET | ||||||||
| Address2: | 11TH FLOOR 11B.17.5 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770302514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137988180 | ||||||||
| FaxNumber: | 7137980111 | ||||||||
| Practice Location | |||||||||
| Address1: | 6720 BERTNER AVENUE | ||||||||
| Address2: | CHI BAYLOR ST LUKE HOSPITAL | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770303411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8323551000 | ||||||||
| FaxNumber: | 7137980111 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2008 | ||||||||
| LastUpdateDate: | 10/11/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 10/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | N4883 | TX | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | BP10031203 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | N4883 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.