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General NPI Number Information
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NPI Number | 1598124190
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Entity Type | Individual
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Provider Name | OMIANA ABIOLA AJIBADE NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 02/11/2016
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 9055 KATY FWY STE P200
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City | HOUSTON
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State | TX
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Zip | 77024-1624
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Country | US
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Telephone | 713-461-2915
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Fax |
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Provider Business Mailing Address
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Address Line | 6720 BERTNER AVE SUITE P115
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City | HOUSTON
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State | TX
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Zip | 77030-2604
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Country | US
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Telephone | 832-355-3994
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP129665
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | AP129665
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License Number State | TX
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