Provider Demographics
NPI:1457848327
Name:PRATT, OLADAYO TAIWO (APN)
Entity type:Individual
Prefix:MRS
First Name:OLADAYO
Middle Name:TAIWO
Last Name:PRATT
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17189 INTERSTATE 45 S STE 395
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77385-3319
Mailing Address - Country:US
Mailing Address - Phone:936-270-3662
Mailing Address - Fax:936-270-3665
Practice Address - Street 1:17189 INTERSTATE 45 S
Practice Address - Street 2:SUITE 395
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77385-3319
Practice Address - Country:US
Practice Address - Phone:936-270-3662
Practice Address - Fax:936-270-3665
Is Sole Proprietor?:No
Enumeration Date:2018-04-17
Last Update Date:2024-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00807800363LF0000X, 363LX0001X
TX1170256363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology