ADELINE MEMORIAL MEDICAL GROUP PLLC
NPI 1760075667
Nurse Practitioner - Family in Rosenberg, TX

Active since February 11, 2021CLIA Certified · 2 labs
3200 AVENUE I, ROSENBERG, TX 77471(832) 344-3650 Get Directions Write a Review

NPPES record last updated: August 6, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 6, 2025, Aug 17, 2024, Apr 18, 2024 and 3 more (6 updates tracked since 2021).

About Adeline Memorial Medical Group Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADELINE MEMORIAL MEDICAL GROUP PLLC (NPI 1760075667) is a healthcare organization registered as a family in Rosenberg, Texas and active in the NPI registry since February 2021. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Houston, and lists Funmilola O Odutayo, Provider, as its authorized official.

NPPES Registry Identity

NPI1760075667
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameADELINE MEMORIAL MEDICAL GROUP PLLC
Location Address3200 AVENUE IRosenberg, TX 77471-3630
Mailing Address3200 Avenue IRosenberg, TX 77471-3630 · (832) 344-3650
Organization SubpartNo
Authorized OfficialFunmilola O OdutayoProvider · (832) 344-3650
Enumeration DateFebruary 11, 2021
Last NPPES UpdateAugust 6, 20256 updates tracked since enumeration
NPPES CertifiedAugust 6, 2025
NPI 1760075667 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Also ListedPediatricsTaxonomy 208000000X
3200 AVENUE I, Rosenberg, TX 77471

Secondary Practice Location 1

Location 16515 Corporate Dr Ste D1Houston, TX 77036-3426 · Phone (713) 981-5166 · Fax (713) 981-5288

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2321316

Adeline Memorial Medical Group PLLC · Rosenberg, TX
Active · expires Apr 1, 2027
CLIA Number45D2321316
Laboratory TypePhysician Office
Certificate Effective DateApril 2, 2025
Certificate Expiration DateApril 1, 2027
Laboratory DirectorOdutayo Funmilola
Laboratory Phone(832) 344-3650
Laboratory LocationAdeline Memorial Medical Group PLLC3200 Avenue I, Rosenberg, TX 77471
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 45D2321314

Adeline Memorial Medical Group PLLC · Houston, TX
Active · expires Apr 1, 2027
CLIA Number45D2321314
Laboratory TypePhysician Office
Certificate Effective DateApril 2, 2025
Certificate Expiration DateApril 1, 2027
Laboratory DirectorFunmilola Odutayo
Laboratory Phone(713) 981-5166
Laboratory LocationAdeline Memorial Medical Group PLLC6515 Corporate Dr Suite D-1, Houston, TX 77036
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
3200 AVENUE I
ROSENBERG, TX 77471

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Adeline Memorial Medical Group PLLC's NPI number?

The NPI number for Adeline Memorial Medical Group PLLC is 1760075667. It was assigned to this organization in the NPPES registry on February 11, 2021.

Where is Adeline Memorial Medical Group PLLC located?

Adeline Memorial Medical Group PLLC is located at 3200 Avenue I, Rosenberg, TX 77471. The listed phone number is (832) 344-3650.

What is Adeline Memorial Medical Group PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Adeline Memorial Medical Group PLLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Adeline Memorial Medical Group PLLC accept?

Health plans from Molina Healthcare and WellPoint list Adeline Memorial Medical Group PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Adeline Memorial Medical Group PLLC was last updated on August 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.