Provider Demographics
NPI:1558843300
Name:OGUNJIMI, THERESA OMOTOYOSI
Entity Type:Individual
Prefix:MISS
First Name:THERESA
Middle Name:OMOTOYOSI
Last Name:OGUNJIMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13250 WESTHEIMER RD APT 259
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-3588
Mailing Address - Country:US
Mailing Address - Phone:713-922-0343
Mailing Address - Fax:
Practice Address - Street 1:13250 WESTHEIMER RD APT 259
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-3588
Practice Address - Country:US
Practice Address - Phone:713-922-0343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX325225164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse