Provider Demographics
NPI:1750858809
Name:AWOBONA, ABIOLA (MS, RD, LD, CDCES)
Entity Type:Individual
Prefix:
First Name:ABIOLA
Middle Name:
Last Name:AWOBONA
Suffix:
Gender:F
Credentials:MS, RD, LD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10750 BARKER CYPRESS RD
Mailing Address - Street 2:STE 104
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-2282
Mailing Address - Country:US
Mailing Address - Phone:832-271-6796
Mailing Address - Fax:
Practice Address - Street 1:5420 DASHWOOD DR STE 301
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-5360
Practice Address - Country:US
Practice Address - Phone:832-578-0726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-26
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86055961133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered