Provider Demographics
NPI:1255649596
Name:UWAIFO, OMOSEDE (NP)
Entity Type:Individual
Prefix:
First Name:OMOSEDE
Middle Name:
Last Name:UWAIFO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 S MASON RD STE 550
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-3874
Mailing Address - Country:US
Mailing Address - Phone:917-214-9997
Mailing Address - Fax:281-895-3083
Practice Address - Street 1:5718 WESTHEIMER RD FL 4
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-5745
Practice Address - Country:US
Practice Address - Phone:917-214-9997
Practice Address - Fax:281-895-3083
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-21
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY632814163W00000X
NYF345337363LF0000X
TXAP138412363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse