Provider Demographics
NPI:1366060279
Name:ABIOYE, TAIWO ITUNUOLUWA (PMHNP)
Entity type:Individual
Prefix:DR
First Name:TAIWO
Middle Name:ITUNUOLUWA
Last Name:ABIOYE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7362 REMCON CIR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1623
Mailing Address - Country:US
Mailing Address - Phone:940-400-9066
Mailing Address - Fax:915-257-6295
Practice Address - Street 1:7362 REMCON CIR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1623
Practice Address - Country:US
Practice Address - Phone:940-400-9066
Practice Address - Fax:915-257-6295
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX896980163WP0808X
TX1002449363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1366060279Medicaid