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General NPI Number Information
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NPI Number | 1528925732
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Entity Type | Organization
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Legal Business Name | FREEDOMCHOICE FAMILY CLINIC
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Dates
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Enumeration Date | 01/08/2026
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 1225 FARR ST
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City | WALLER
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State | TX
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Zip | 77484-8486
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Country | US
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Telephone | 936-372-3003
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Fax | 936-372-8070
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Provider Business Mailing Address
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Address Line | 1225 FARR ST
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City | WALLER
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State | TX
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Zip | 77484-8486
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Country | US
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Telephone | 936-372-3003
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Fax | 936-372-8070
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Authorized Official
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Title or Position | OWNER
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Name | OMOBOLA ABOSEDE PETINRIN
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Credential | FNP
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Telephone | 936-372-3003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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