Provider Demographics
NPI:1649770868
Name:TUBI, OLUWAKEMI
Entity Type:Individual
Prefix:
First Name:OLUWAKEMI
Middle Name:
Last Name:TUBI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:TUBI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8585 SIENNA SPRINGS BLVD APT 1021
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-7205
Mailing Address - Country:US
Mailing Address - Phone:281-813-5318
Mailing Address - Fax:
Practice Address - Street 1:8585 SIENNA SPRINGS BLVD APT 1021
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-7205
Practice Address - Country:US
Practice Address - Phone:281-813-5318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-14
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2014941251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY$$$$$$$$$OtherHEALTH INSURANCE