Provider Demographics
NPI:1184309114
Name:FOWOWE, DAMILOLA OMOLABAKE (PMHNP)
Entity type:Individual
Prefix:
First Name:DAMILOLA
Middle Name:OMOLABAKE
Last Name:FOWOWE
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 1:27700 NORTHWEST FWY #340, CYPRESS, TX 77433
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-1032
Mailing Address - Country:US
Mailing Address - Phone:346-577-9157
Mailing Address - Fax:
Practice Address - Street 1:27700 NORTHWEST FWY STE 340
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-6767
Practice Address - Country:US
Practice Address - Phone:346-577-9157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1073933363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health