Provider Demographics
NPI:1558728287
Name:IGBALAJOBI, TOLU (DR)
Entity Type:Individual
Prefix:
First Name:TOLU
Middle Name:
Last Name:IGBALAJOBI
Suffix:
Gender:F
Credentials:DR
Other - Prefix:
Other - First Name:TONI
Other - Middle Name:
Other - Last Name:MATTHEW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DR
Mailing Address - Street 1:5351 ANTOINE DR STE B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77091-4999
Mailing Address - Country:US
Mailing Address - Phone:713-271-8500
Mailing Address - Fax:
Practice Address - Street 1:5351 ANTOINE DR STE B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091-4999
Practice Address - Country:US
Practice Address - Phone:713-271-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-26
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No172V00000XOther Service ProvidersCommunity Health Worker