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NPI Code Detail

MEDICARE: MR. ADEBAYO ADEBOWALE PMHNP-BC

MEDICARE: MR. ADEBAYO ADEBOWALE PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner1017508TX

General Provider Information

NPI Number : 1417562349
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ADEBAYO ADEBOWALE PMHNP-BC
Provider Business Mailing Address
First Line : 20422 ALPINE MEADOW PL
Second Line :
City : RICHMOND
State : TX
Zip : 77407-2583
Country : US
Telephone Number : 832-630-2570
Fax Number :
Provider Business Practice Location Address
First Line : 201 KINGWOOD MEDICAL DR STE A450
Second Line :
City : KINGWOOD
State : TX
Zip : 77339-6027
Country : US
Telephone Number : 832-701-0283
Fax Number : 281-608-7543
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2020
Last Update Date : 06/09/2025

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