Provider Demographics
NPI:1750528246
Name:KAYODE, OLUBUNKANLA OJUBAYO (FNP)
Entity type:Individual
Prefix:MS
First Name:OLUBUNKANLA
Middle Name:OJUBAYO
Last Name:KAYODE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:OLUBUNKANLA
Other - Middle Name:OJUBAYO
Other - Last Name:KAYODE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:8754 SPRING CYPRESS RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3135
Mailing Address - Country:US
Mailing Address - Phone:646-528-3084
Mailing Address - Fax:
Practice Address - Street 1:26265 NORTHWEST FWY
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1760
Practice Address - Country:US
Practice Address - Phone:646-528-3084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2021-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP117353363LF0000X
TXAPRN117353363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L9404Medicare PIN
TX8L9401Medicare PIN
TX8L9403Medicare PIN