Healthcare Provider Details

I. General information

NPI: 1467645283
Provider Name (Legal Business Name): OLAYINKA M AYENI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 02/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 CYPRESSWOOD DR STE 219
SPRING TX
77379-7893
US

IV. Provider business mailing address

6 N ABRAM CIR
SPRING TX
77382-2037
US

V. Phone/Fax

Practice location:
  • Phone: 281-803-5880
  • Fax:
Mailing address:
  • Phone: 281-364-3546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberP5329
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number04703
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberP5329
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: