Provider Demographics
NPI:1972044741
Name:OJO, ADESUWA
Entity Type:Individual
Prefix:
First Name:ADESUWA
Middle Name:
Last Name:OJO
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 1:1717 TURNING BASIN DR STE 148
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77029-4165
Mailing Address - Country:US
Mailing Address - Phone:183-257-2557
Mailing Address - Fax:832-575-5577
Practice Address - Street 1:6846 ANTOINE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091-1210
Practice Address - Country:US
Practice Address - Phone:832-794-4402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-13
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132243363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily