Provider Demographics
NPI:1083213912
Name:ORESANYA, WALIYYAT
Entity Type:Individual
Prefix:
First Name:WALIYYAT
Middle Name:
Last Name:ORESANYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11822 APPLE BLUFF CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-6476
Mailing Address - Country:US
Mailing Address - Phone:832-566-9874
Mailing Address - Fax:
Practice Address - Street 1:20355 CYPRESSWOOD DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-6477
Practice Address - Country:US
Practice Address - Phone:832-952-3180
Practice Address - Fax:832-952-3182
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX498991835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist