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Contact Information

ADELINE MEMORIAL MEDICAL GROUP PLLC
3200 AVENUE I
ROSENBERG, TX77471-3630
 Phone: 832-344-3650
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for ADELINE MEMORIAL MEDICAL GROUP PLLC

NPI Number 1760075667
LBN Legal business name ADELINE MEMORIAL MEDICAL GROUP PLLC
Authorized official FUNMILOLA ODUTAYO - (PROVIDER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/11/2021
Last updated 08/06/2025 - About 10 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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