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General NPI Number Information
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NPI Number | 1215398532
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Entity Type | Individual
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Provider Name | EYITAYO ODENIYI DNP, GNP-BC, PMHNP-B
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Gender | Male
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Dates
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Enumeration Date | 03/14/2016
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 126 MAIN PLZ
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City | SAN ANTONIO
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State | TX
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Zip | 78205-2745
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Country | US
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Telephone | 888-365-6271
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Fax | 877-312-2585
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Provider Business Mailing Address
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Address Line | 126 MAIN PLZ
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City | SAN ANTONIO
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State | TX
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Zip | 78205-2745
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Country | US
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Telephone | 888-365-6271
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Fax | 713-234-7915
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP116347
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AP116347
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License Number State | TX
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