Provider Demographics
NPI:1043710684
Name:AJAYI, OLAREWAJU OPAGINI
Entity Type:Individual
Prefix:
First Name:OLAREWAJU
Middle Name:OPAGINI
Last Name:AJAYI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2830 HAZELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-3295
Mailing Address - Country:US
Mailing Address - Phone:713-562-8821
Mailing Address - Fax:
Practice Address - Street 1:2830 HAZELWOOD DR
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-3295
Practice Address - Country:US
Practice Address - Phone:713-562-8821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX894908163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse