Provider Demographics
NPI:1417830654
Name:OBAFEMI, MAYOWA (RN)
Entity type:Individual
Prefix:
First Name:MAYOWA
Middle Name:
Last Name:OBAFEMI
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13802 MARTINGALE POINTE DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-8394
Mailing Address - Country:US
Mailing Address - Phone:713-839-6554
Mailing Address - Fax:
Practice Address - Street 1:13802 MARTINGALE POINTE DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-8394
Practice Address - Country:US
Practice Address - Phone:713-839-6554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1067653163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse