Provider Demographics
NPI:1235314451
Name:OGUNYOKU, TAJUDEEN KOLAWOLE
Entity Type:Individual
Prefix:MR
First Name:TAJUDEEN
Middle Name:KOLAWOLE
Last Name:OGUNYOKU
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 1:11555 BISSONNET ST
Mailing Address - Street 2:P.O.BOX 720843
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-5500
Mailing Address - Country:US
Mailing Address - Phone:832-681-0013
Mailing Address - Fax:
Practice Address - Street 1:11555 BISSONNET ST
Practice Address - Street 2:SUITE 1015
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-5500
Practice Address - Country:US
Practice Address - Phone:713-448-9670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service