Provider Demographics
NPI:1760796031
Name:OWOJORI, TITILAYO
Entity Type:Individual
Prefix:
First Name:TITILAYO
Middle Name:
Last Name:OWOJORI
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 1:1000 W FRANK AVE
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3301
Mailing Address - Country:US
Mailing Address - Phone:936-634-7083
Mailing Address - Fax:936-634-7091
Practice Address - Street 1:1000 W FRANK AVE
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3301
Practice Address - Country:US
Practice Address - Phone:936-634-7083
Practice Address - Fax:936-634-7091
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48178183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist