Provider Demographics
NPI:1164502589
Name:HAMED, OLUWAKEMI ABIOLA (PAC)
Entity Type:Individual
Prefix:
First Name:OLUWAKEMI
Middle Name:ABIOLA
Last Name:HAMED
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 FANNIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2316
Mailing Address - Country:US
Mailing Address - Phone:832-824-6230
Mailing Address - Fax:832-825-6229
Practice Address - Street 1:6701 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2316
Practice Address - Country:US
Practice Address - Phone:832-824-6230
Practice Address - Fax:832-825-6229
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04278363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q45553Medicare UPIN
TX8L6509Medicare PIN
TX8D5764Medicare PIN