Basic Information
| Provider Information | |||||||||
| NPI: | 1053773804 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AJALA | ||||||||
| FirstName: | ABAYOMI | ||||||||
| MiddleName: | MICHAEL | ||||||||
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| Credential: | M.D., MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 909 FROSTWOOD DR STE 1.100 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770242301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7133385519 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7600 BEECHNUT ST | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770744302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134565686 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2016 | ||||||||
| LastUpdateDate: | 01/25/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | T1629 | TX | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | T1629 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD468060 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.