Provider Demographics
NPI:1205968393
Name:THOMAS-OGUNNIYI, JAIYEOLA O (MD)
Entity type:Individual
Prefix:
First Name:JAIYEOLA
Middle Name:O
Last Name:THOMAS-OGUNNIYI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JAIYEOLA
Other - Middle Name:OLAYEMI
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6431 FANNIN STREET
Mailing Address - Street 2:MSB 2.136
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-500-5301
Mailing Address - Fax:713-500-0695
Practice Address - Street 1:6431 FANNIN STREET
Practice Address - Street 2:MSB 2.136
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-5301
Practice Address - Fax:713-500-0695
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD201911207ZC0500X, 207ZP0101X
TXP5485207ZC0500X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology