Provider Demographics
NPI:1215686738
Name:OMOYAJOWO, TITI (APN)
Entity type:Individual
Prefix:MRS
First Name:TITI
Middle Name:
Last Name:OMOYAJOWO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:TITI
Other - Middle Name:FOLUKE
Other - Last Name:OMOJOWO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OYAWUSI
Mailing Address - Street 1:9894 BISSONNET ST STE 210
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8246
Mailing Address - Country:US
Mailing Address - Phone:713-485-4705
Mailing Address - Fax:713-730-3639
Practice Address - Street 1:9894 BISSONNET ST STE 210
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8246
Practice Address - Country:US
Practice Address - Phone:973-517-1736
Practice Address - Fax:713-730-3639
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-22
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1072245363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty