Provider Demographics
NPI:1841972304
Name:AKINBOBOYE, OLUTAYO (PT, DPT)
Entity type:Individual
Prefix:
First Name:OLUTAYO
Middle Name:
Last Name:AKINBOBOYE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 MCCUE RD APT 164
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-4322
Mailing Address - Country:US
Mailing Address - Phone:845-541-3541
Mailing Address - Fax:
Practice Address - Street 1:23910 KATY FWY STE 100
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1477
Practice Address - Country:US
Practice Address - Phone:281-500-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1379221225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist