Healthcare Provider Details

I. General information

NPI: 1417454992
Provider Name (Legal Business Name): ABIOLA OYEMADE PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 LAKE POINTE PKWY STE 104
SUGAR LAND TX
77478-4077
US

IV. Provider business mailing address

1235 LAKE POINTE PKWY STE 104
SUGAR LAND TX
77478-4077
US

V. Phone/Fax

Practice location:
  • Phone: 844-824-8775
  • Fax: 281-648-2200
Mailing address:
  • Phone: 844-824-8775
  • Fax: 281-648-2200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number265264
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number734624
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP137533
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: