Provider Demographics
NPI:1235227380
Name:OMIGIE, ADESUWA A (RN FNP-BC, PMHNP)
Entity Type:Individual
Prefix:
First Name:ADESUWA
Middle Name:A
Last Name:OMIGIE
Suffix:
Gender:F
Credentials:RN FNP-BC, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14522 S POST OAK RD
Mailing Address - Street 2:STE.203B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77045-6037
Mailing Address - Country:US
Mailing Address - Phone:713-434-9270
Mailing Address - Fax:
Practice Address - Street 1:14522 S POST OAK RD
Practice Address - Street 2:STE.203B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77045-6037
Practice Address - Country:US
Practice Address - Phone:713-434-9270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX626826363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily