Provider Demographics
NPI:1508497108
Name:ADIO ODUOLA, OLAWALE H (PMHNP)
Entity Type:Individual
Prefix:MR
First Name:OLAWALE
Middle Name:H
Last Name:ADIO ODUOLA
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15500 VOSS RD STE 1045
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-4601
Mailing Address - Country:US
Mailing Address - Phone:713-309-6406
Mailing Address - Fax:949-863-2663
Practice Address - Street 1:15500 VOSS RD STE 1045
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-4601
Practice Address - Country:US
Practice Address - Phone:713-309-6406
Practice Address - Fax:949-863-2663
Is Sole Proprietor?:No
Enumeration Date:2020-02-01
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144900363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health