Provider Demographics
NPI:1033855507
Name:JEJELOWO, SHAMIR (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:SHAMIR
Middle Name:
Last Name:JEJELOWO
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 WESTHEIMER RD STE 425
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7699
Mailing Address - Country:US
Mailing Address - Phone:281-729-5771
Mailing Address - Fax:
Practice Address - Street 1:5959 WESTHEIMER RD STE 425
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7699
Practice Address - Country:US
Practice Address - Phone:832-463-1933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-09
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX862567163W00000X
TX1079279363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse