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General NPI Number Information
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NPI Number | 1174291926
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Entity Type | Individual
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Provider Name | OLUWATOYOSI OLUMIDE
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Gender | Female
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Dates
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Enumeration Date | 09/04/2021
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Last Update Date | 09/04/2021
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Provider Practice Location Address
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Address Line | 2201 ARBOR ST
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City | HOUSTON
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State | TX
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Zip | 77004-6026
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Country | US
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Telephone | 833-430-4807
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Fax |
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Provider Business Mailing Address
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Address Line | 11355 RICHMOND AVE APT 1721
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City | HOUSTON
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State | TX
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Zip | 77082-7662
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Country | US
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Telephone | 512-785-3151
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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License Number | 1050077
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1050077
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License Number State | TX
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