Provider Demographics
NPI:1881470813
Name:ABUBAKAR, MOHAMMED OLADIMEJI (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:OLADIMEJI
Last Name:ABUBAKAR
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13450 CRICKLEWOOD CREEK LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-6072
Mailing Address - Country:US
Mailing Address - Phone:281-556-3838
Mailing Address - Fax:
Practice Address - Street 1:5314 DASHWOOD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-4603
Practice Address - Country:US
Practice Address - Phone:713-600-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1112294363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health