Provider Demographics
NPI:1083378095
Name:TAIWO, ABAYOMI ALLEN
Entity Type:Individual
Prefix:
First Name:ABAYOMI
Middle Name:ALLEN
Last Name:TAIWO
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 1:9800 CENTRE PKWY STE 265
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8468
Mailing Address - Country:US
Mailing Address - Phone:281-888-6632
Mailing Address - Fax:
Practice Address - Street 1:9800 CENTRE PKWY STE 265
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8468
Practice Address - Country:US
Practice Address - Phone:281-888-6632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No341600000XTransportation ServicesAmbulance
No3416A0800XTransportation ServicesAmbulanceAir Transport
No3416L0300XTransportation ServicesAmbulanceLand Transport
No347C00000XTransportation ServicesPrivate Vehicle