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General NPI Number Information
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NPI Number | 1255943742
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Entity Type | Individual
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Provider Name | TAIYE O OGUNMAKIN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/18/2020
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 1812 CENTRE CREEK DR STE 115
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City | AUSTIN
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State | TX
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Zip | 78754-5133
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Country | US
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Telephone | 512-579-0026
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Fax |
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Provider Business Mailing Address
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Address Line | 2210 MID LN
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City | HOUSTON
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State | TX
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Zip | 77027-3845
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Country | US
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Telephone | 713-884-0562
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 58865
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License Number State | TX
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