Provider Demographics
NPI:1417566688
Name:AJAYI, OLAJUMOKE FOLUKE (N/A)
Entity type:Individual
Prefix:MS
First Name:OLAJUMOKE
Middle Name:FOLUKE
Last Name:AJAYI
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:MR
Other - First Name:ANTHONY
Other - Middle Name:EHI
Other - Last Name:AIDONMIYI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:N/A
Mailing Address - Street 1:9555 W SAM HOUSTON PKWY S STE 410
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-2168
Mailing Address - Country:US
Mailing Address - Phone:832-689-6321
Mailing Address - Fax:713-800-4999
Practice Address - Street 1:9555 WEST SAM HOUSTON PWKY S.
Practice Address - Street 2:410
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099
Practice Address - Country:US
Practice Address - Phone:832-689-6321
Practice Address - Fax:713-800-4999
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX019928251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health