Provider Demographics
NPI:1881011385
Name:AFOLABI, OLUWAFERANMI J (PMHNP)
Entity Type:Individual
Prefix:
First Name:OLUWAFERANMI
Middle Name:J
Last Name:AFOLABI
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17401 W LAKE HOUSTON PKWY APT 7204
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-5147
Mailing Address - Country:US
Mailing Address - Phone:281-594-8953
Mailing Address - Fax:
Practice Address - Street 1:3663 N SAM HOUSTON PKWY E STE 600
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77032-3611
Practice Address - Country:US
Practice Address - Phone:281-594-8953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-21
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY682451163WH0200X
TX903815163W00000X
TX1107104363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse