Provider Demographics
NPI:1083010334
Name:AJANAKU-UDEH, FOLUKE
Entity type:Individual
Prefix:
First Name:FOLUKE
Middle Name:
Last Name:AJANAKU-UDEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 WESTPARK DR
Mailing Address - Street 2:STE 212
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7205
Mailing Address - Country:US
Mailing Address - Phone:713-339-2273
Mailing Address - Fax:713-339-1130
Practice Address - Street 1:6300 WESTPARK DR
Practice Address - Street 2:STE 212
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7205
Practice Address - Country:US
Practice Address - Phone:713-339-2273
Practice Address - Fax:713-339-1130
Is Sole Proprietor?:No
Enumeration Date:2014-11-14
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1152653225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist