Provider Demographics
NPI:1427406834
Name:AJIBADE, TAOFEEKAT FOLASHADE (NP-C)
Entity Type:Individual
Prefix:
First Name:TAOFEEKAT
Middle Name:FOLASHADE
Last Name:AJIBADE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16605 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 175
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3501
Mailing Address - Country:US
Mailing Address - Phone:281-491-6767
Mailing Address - Fax:281-565-1112
Practice Address - Street 1:16605 SOUTHWEST FWY
Practice Address - Street 2:SUITE 175
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3501
Practice Address - Country:US
Practice Address - Phone:281-491-6767
Practice Address - Fax:281-565-1112
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130653363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily