Provider Demographics
NPI:1467057430
Name:TAIWO, OMOWUNMI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:OMOWUNMI
Middle Name:
Last Name:TAIWO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:OMOWUNMI
Other - Middle Name:ABIOLA
Other - Last Name:TAIWO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:9614 GARRETT DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-4848
Mailing Address - Country:US
Mailing Address - Phone:713-240-2639
Mailing Address - Fax:
Practice Address - Street 1:8626 LAKEVIEW PKWY
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-9306
Practice Address - Country:US
Practice Address - Phone:713-240-2639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41911183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist